Obstructive Lung Diseases |

High Resolution Computed Tomography Features Associated With Frequent Acute Exacerbations in COPD Patients FREE TO VIEW

Prem Parkash Gupta, MD; Rohtas Yadav, MD; Manjunath Govindagoudar, MBBS
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Dept. of Respiratory Medicine, PGIMS, Rohtak, India

Chest. 2013;144(4_MeetingAbstracts):681A. doi:10.1378/chest.1698585
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SESSION TITLE: Acute exacerbations of COPD

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Wednesday, October 30, 2013 at 02:45 PM - 04:15 PM

PURPOSE: To assess HRCT characteristics in COPD patients associated with frequent acute exacerbations.

METHODS: We included 80 COPD patients: 40 patients had ≥ 2 acute exacerbations (FECOPD Group) and 40 patients had < 2 acute exacerbations (I-FECOPD Group) during preceding one year. Patients` baseline data was collected. HRCT scans were obtained to assess: type of emphysema, distribution of emphysema, extent of emphysema, mosaic attenuation pattern, major airways wall thickness, visibility of small airways, vascular attenuation, vascular distortion and parameters of hyperinflation.

RESULTS: The age of patients in FECOPD group and I-FECOPD group was 60.15±11.19 year and 62.28±7.82 year, respectively. HRCT features of emphysema were found in 25 patients in FECOPD group and 19 patients in I-FECOPD group. Panacinar, centriacinar and paraseptal emphysema were observed in 9, 18 and 12 patients in FECOPD group and 7, 10 and 7 patients in I-FECOPD group, respectively; emphysema scores were 3.15±3.27 and 1.75±2.30, respectively (p value = 0.03). Mosaic attenuation pattern was observed in 12 patients in FECOPD group and 9 patients in I-FECOPD group. Small airways were directly visible in 31 patients in FECOPD group and 26 in I-FECOPD group, (p=0.217). Major airways wall thickness was 1.48±0.32 mm and 1.31±0.25 mm in FECOPD group and I-FECOPD group, respectively (p=0.013). In FECOPD group, 20 had vascular attenuation and 8 had vascular distortion. In I-FECOPD group, 15 had vascular attenuation and 7 had vascular distortion (P>0.05). FECOPD group had features of severe hyperinflation compared to I-FECOPD group (for all p<0.05): tracheal index (0.70±0.13 vs. 0.76±0.13), sterno-aortic distance (3.26 ±0.85 cm vs. 2.90±0.83 cm), thoracic cage ratio at carina (72.09±4.24 vs. 69.62±4.21), thoracic cage ratio 5 cm below carina (75.45±4.50 vs. 73.12±4.48), and thoracic cross sectional area (268.94±36.85 cm2 vs. 251.07±32.75 cm2).

CONCLUSIONS: We observed distinct HRCT features associated with frequent acute exacerbations in COPD.

CLINICAL IMPLICATIONS: It would be interesting to predict acute exacerbations in COPD using HRCT characteristics, which may help in preemptive management of exacerbations.

DISCLOSURE: The following authors have nothing to disclose: Prem Parkash Gupta, Rohtas Yadav, Manjunath Govindagoudar

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