Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.
Airway Obstruction ; Humans ; Phenotype ; Pulmonary Disease, Chronic Obstructive/diagnostic imaging* ; Pulmonary Emphysema/diagnostic imaging* ; Tomography, X-Ray Computed

Aged ; Anthracosis ; complications ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Pulmonary Emphysema ; complications ; diagnostic imaging ; Tomography, Spiral Computed ; Trachea ; diagnostic imaging ; pathology

OBJECTIVETo explore the sensitivity and accuracy of CT and HRCT in early detection of coal-worker's pneumoconiosis (CWP) associated micronodules, nodule coalescence and emphysema from coal miners with and without radiographic CWP evidence.

METHODContinuously Thorax-Vol. CT scanning and High resolution CT scanning were performed on 113 coal miners with or without radiographic CWP evidence and 37 health controls by the use of Multi Spiral Computed Tomography (MSCT). The CT and HRCT images were evaluated for lung parenchyma opacity profusion category, nodule coalescence, emphysema index and mean lung attenuation, and then compared with that on radiographs.

RESULTGood agreement for CWP associated opacity profusion grading was achieved between radiographs and CT scans (Kappa = 0.771). The sensitivity of CT and HRCT were 98.70% for CWP diagnosis when compared with radiographs. 8 (22.22%) cases out of 36 radiographic CWP negative coal miners were categorized as grade 1 opacity profusion in consistent with CWP on CT and HRCT scans, and 26 (35.62%) cases out of 73 radiographic grade 1-2 CWP patients were detected to have at least grade 3 nodular profusion on CT and HRCT scans. Among 113 coal miners, 36 (31.86%) were recognized as emphysema positive on CT; whereas only 7 (6.19%) on radiographs. According to CT opacity profusion grading, mean lung attenuation in coal miners with grade 1-2 opacity profusion classification was significantly increased than that in health control, CWP negative coal miner and grade 4 opacity profusion groups (F1 = -45.73, F2 = -23.00 and F3 = 52.72, P < 0.01 and P < 0.05).

CONCLUSIONCT and HRCT acquired from MSCT showed high sensitive and accurate for the early detection of micronodules, nodule coalescence and emphysema in coal miners. It could be used as semi-quantitative and quantitative method in early diagnosis of CWP and its complications.

Adult ; Aged ; Anthracosis ; diagnostic imaging ; Case-Control Studies ; Early Diagnosis ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Pulmonary Emphysema ; diagnostic imaging ; Sensitivity and Specificity ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; methods

Adult ; Age Factors ; Aged ; Chronic Disease ; Electrocardiography ; Female ; Humans ; Lung Diseases, Obstructive ; diagnostic imaging ; etiology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Emphysema ; etiology ; Radiography ; Respiratory Function Tests ; Sex Factors ; Smoking