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Am. J. Respir. Crit. Care Med., Volume 162, Number 3, September 2000, 1102-1108

Computed Tomographic Measurements of Airway Dimensions and Emphysema in Smokers
Correlation with Lung Function

YASUTAKA NAKANO, SHIGEO MURO, HIROAKI SAKAI, TOYOHIRO HIRAI, KAZUO CHIN, MITSUHIRO TSUKINO, KOICHI NISHIMURA, HARUMI ITOH, PETER D. PARÉ, JAMES C. HOGG, and MICHIAKI MISHIMA

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Departments of Physical Therapeutics, and Radiology and Nuclear Medicine, Kyoto University Hospital, Kyoto, Japan; and University of British Columbia Pulmonary Research Laboratory, St. Paul's Hospital, Vancouver, British Columbia, Canada

Chronic obstructive pulmonary disease (COPD) is characterized by the presence of airflow obstruction caused by emphysema or airway narrowing, or both. Low attenuation areas (LAA) on computed tomography (CT) have been shown to represent macroscopic or microscopic emphysema, or both. However CT has not been used to quantify the airway abnormalities in smokers with or without airflow obstruction. In this study, we used CT to evaluate both emphysema and airway wall thickening in 114 smokers. The CT measurements revealed that a decreased FEV1 (%predicted) is associated with an increase of airway wall area and an increase of emphysema. Although both airway wall thickening and emphysema (LAA) correlated with measurements of lung function, stepwise multiple regression analysis showed that the combination of airway and emphysema measurements improved the estimate of pulmonary function test abnormalities. We conclude that both CT measurements of airway dimensions and emphysema are useful and complementary in the evaluation of the lung of smokers.




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