Computed tomography manifestation of acute exacerbation of chronic obstructive pulmonary disease: A pilot study

Cheng,Ting; Wan,Huanying; Cheng,Qijian; Guo,Yi; Qian,Yanrong; Fan,Liang; Feng,Yun; Song,Yanyan; Zhou,Min; Li,Qingyun; Shi,Guochao; Huang,Shaoguang

doi:10.3892/etm.2015.2930

Computed tomography manifestation of acute exacerbation of chronic obstructive pulmonary disease: A pilot study

Authors:
- Ting Cheng
- Huanying Wan
- Qijian Cheng
- Yi Guo
- Yanrong Qian
- Liang Fan
- Yun Feng
- Yanyan Song
- Min Zhou
- Qingyun Li
- Guochao Shi
- Shaoguang Huang
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Affiliations: Department of Respiratory Medicine, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai 201800, P.R. China, Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China, Department of Biostatistics, Shanghai Jiaotong University School of Medicine, Shanghai 200025, P.R. China
Published online on: December 11, 2015 https://doi.org/10.3892/etm.2015.2930
Pages: 519-529

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Abstract

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is an acute event characterized by the worsening of a patient's respiratory symptoms. To the best of our knowledge, few studies have investigated the computed tomography (CT) manifestation of AECOPD. Thus, the aim of the present study was to examine the CT manifestations during AECOPD. In total, 40 patients with AECOPD admitted to the emergency department were enrolled. CT images obtained at the time of exacerbation and at the 3‑month follow‑up were paired. Clinical characteristics and routine blood test results were also recorded. Airway dimensions and attenuation per patient were quantified from the 3rd to the 6th generation of four bronchi by Airway Inspector Slicer 2.8. The emphysema extent was also quantified and lung infiltration was detected, classified and measured. The CT images showed an increased wall area percentage (WA%) and increased mean and peak wall attenuation during the AECOPD; however, the extent of emphysema did not change significantly. In total, 60% of AECOPD patients presented with lung infiltration, compared with those at the follow‑up CT scanning. The presence and extent of segmental distribution consolidation was correlated with the neutrophil percentage (N%), with a statistically significant difference observed. The total volume of lung parenchymal infiltration was correlated with the white blood cell (WBC) count and N%; however, no significant correlations were detected between the presence or extent of acinar shadow, air space consolidation with lobular distribution, ground‑glass attenuation with lobular distribution, thickening of the interlobular septa and signs of infection (including the number of main symptoms, body temperature, WBC count and N%). The WA%, mean wall attenuation and peak wall attenuation increased during AECOPD, but the emphysema extent was unchanged. Lung infiltration existed frequently; however, only consolidation with segmental distribution appeared to be associated with bacterial infection.

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