Source: Annual Congress 2002 - Oncology imaging: CT, MRI and PET
Disease area: Airway diseases

Abstract

A significant proportion of patients with COPD report symptoms of daily cough and sputum production. Lower airway bacterial colonisation is also a feature of this condition. High resolution CT scanning (HRCT) is not routinely performed in COPD and the prevalence of bronchiectasis in these patients has not been established. 54 moderate/ severe COPD patients (mean (SD) age 69 (7) yrs, FEV₁ 0.96 (0.33) l, FEV₁% predicted 38.1 (38.9) %, FEV₁/FVC 40.9 (11.8) %, PaO₂ 8.77 (1.11) kPa, 50.5 (33.5) pack years, daily inhaled steroids 1247.2 (622.6) mcg, 36 (66.7%) males, 16 (29.6%) current smokers, 27 (50%) daily sputum producers) underwent lung HRCTs at 1mm collimation at 1-1.5 cm space intervals in inspiration and expiration. Bronchiectasis was scored from 0-4 per lobe for a total score out of 24 (Smith et al Thorax 1996; 51: 914-8). 39/54 (72.2%) patients had detectable bronchiectasis ( total score >/= 1, range 1-14) while 15/54 (27.8%) had none. Total scores ranged as follows; 1: 12/39 (30.8%); 2: 7/39 (17.9%); 3: 7/39 (17.9%); 4: 5/39 (12.8%); 6: 1/39 (2.6%); 7: 1/39 (2.6%); 8: 2/39 (5.1%); 9: 1/39 (2.6%); 10: 1/39 (2.6%); 13: 1/39 (2.6%); 14: 1/39 (2.6%). 17/39 (43.6%) patients had a cumulative upper lobe score >/= 1 (range 1-5), 18/39 (46.2%) had a cumulative middle lobe score >/= 1 (range 1-5) and 30/39 (76.9%) had a cumulative lower lobe score >/=1 (range 1-8). Total score negatively correlated with PO₂ (rho = - 0.299, p = 0.03). No relationship was seen with spirometric criteria, daily sputum production or pack years of smoking. In this cohort of patients with COPD, a high prevalence of bronchiectasis was found, although in the majority of cases it was not extensive or severe.

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I. S. Patel, I. Vlahos, T. M. A. Wilkinson, S. J. Lloyd-Owen, R. H. Reznek, J. A. Wedzicha (London, United Kingdom). The prevalence and extent of bronchiectasis on high resolution CT scanning in patients with COPD. Eur Respir J 2002; 20: Suppl. 38, 3765

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