Abstract

INTRODUCTION

The aim of this study was to determine the type and extent of emphysema and to investigate the contribution of high resolution computed tomography (HRCT) to diagnosis, compliance with chest X-ray and pulmonary function tests (PFT).

METHODS

Chest X-ray, HRCT, PFT and arterial blood gase analysis were performed. A visual scoring system was used to determine the emphysema grades in HRCT.

RESULTS

Forty-eight patients enrolled in the study were divided according to the severity of emphysema. 17 (35.4%) patients were mild, 17 (35.4%) were moderate and 14 (29.2%) had severe emphysema. Accompanying signs were nonseptal lines, bronchiectatic changes, bullae, nodule, septal lines, pleural thickening, ground glass; respectively. The mean diameter of the right pulmonary artery was 17.18 mm, the diameter of the left pulmonary artery was 17.38 mm, the diameter of the antero-posterior chest wall was 20.12 cm, the vertical diameter was 25.12 cm, the vertical diameter of the heart was 13.08 cm and the ratio of the vertical diameter of the heart to the chest vertical diameter was 0.51.

When the patients were divided into two groups as normal chest X-ray and not, emphysema score was detected 41.2 in the first group and 24.1 in the second. The forced expiratory volüme first second / forced vital capacity ratio was lower in patients with high emphysema scores. The partial carbondioxide level was lower in patients with high emphysema scores.

DISCUSSION AND CONCLUSION

There was a significant negative correlation between the prevalence of emphysema and PFT findings. HRCT is a more sensitive and specific examination method than the standard chest radiograms in the diagnosis, type, prevalence and severity of emphysema. Differential diagnosis of other pulmonary diseases leading to the same clinical feature with chronic obstructive pulmonary disease can be easily performed, and bullae not visible on chest x-ray often can be detected by HRCT.