PULMONARY-EMPHYSEMA - QUANTIFICATION USING COMPUTED-TOMOGRAPHY AND CORRELATIONS WITH RESPIRATORY-FUNCTION TESTS

Pulmonary emphysema can be defined in precise anatomical terms. Only histological examination of an entire lung will enable the extension and the severity of the emphysema to be fully assessed. The authors propose a visual score, using computed tomography to quantify emphysema in 6 subjects. 51 had chronic airflow obstruction (BPCO) and were devided into 31 chronic bronchitics (BC) and 20 emphysematous subjects (EP). 10 volunteers who were free of any respiratory pathology were chosen as controls. A visual score for the computed tomography was established for the subjects as a whole. Double reading of the data enabled the reproducibility of the method to be checked in 10 subjects (r = 0.98, p <0.001). No emphysema was found in the 10 controls, the computed tomography score was appreciably more elevated in the EP subjects than in the BC group at 1.3 and 0.44 respectively (p <0.001). In the BC, the computed tomographic score was not correlated with the PaO2 (r = 0.54, p <0.001) and the FEV1 (VEMS) (r = <0.44, p <0.05). On the other hand, in the PE group, the score was correlated with the FEV1 (r = 0.52, p <0.05) and the residual volume (r = 0.06, p <0.05) and the total lung capacity (r = 0.63, p <0.05) and the TLCO (r = 0.56, p <0.05) and the TLCO/VA (r = 0.59, p <0.05). The adoption of a visual computed tomographic score enabled the authors to find the correlations between pulmonary emphysema and the most specific tests of respiratory function.