Abstract
[BACKGROUND]
High Resolution Computed Tomography Scan (HRCT) is now being used as an important diagnostic test in COPD patients.
In present study, we have evaluated various HRCT features to identify morphological patterns and correlated with clinical features.
[METHODS]
50 patients (42 males and 8 females) of stable COPD attending a tertiary referral hospital were included. According to HRCT findings, 3 predominant patterns were identified as Emphysema, Bronchial wall thickening and Bronchiectasis. This was correlated with smoking status, Body Mass Index, 6 min walk test (6MWT), frequency of exacerbations, and spirometry parameters including bronchodilator reversibility.
[RESULTS]
COPD patients with Emphysema phenotype on HRCT were more severely affected i.e. they had severe COPD as per GOLD guidelines (55%) with lower (<250m) 6MWT values (55%) and poor bronchodilator reversibility (82.50%).
52% COPD patients with bronchial wall thickening phenotype predominantly had severe COPD as per GOLD guidelines with lower (<250m) 6MWT values (72.22%) and poor bronchodilator reversibility (63.88%).
52% COPD patients with bronchiectasis phenotype predominantly had moderate COPD as per GOLD guidelines. They had better (>250m) 6MWT values (73.68%) with good bronchodilator reversibility (68.42%) on spirometry. However, these patients had higher frequency of infective exacerbation compared with other two groups (52.63%).
When 6MWT is compared among emphysema, bronchial wall thickening, bronchiectasis. P value is 0.016 (significant) and F value is 4.341.
[CONCLUSION]
Morphological phenotypes as assessed by HRCT scan may help in identifying patients who will benefit from bronchodilator treatment and can also help to predict severity of COPD.
- © 2014 ERS
