ABSTRACT
PurposeTo measure the areas and diameter lines of bronchi at acute exacerbation and at remission period in patients with chronic obstructive pulmonary disease (COPD) using CT, and to explore the correlation between the two periods and evaluate the comprehensive assessment in diagnosing COPD exacerbation.Materials and Methods Fifty-two COPD patients were scanned with 64-row spiral CT on chest and PFT at acute exacerbation and at remission period. The areas and diameter lines of apical segmental and the sub-segmental bronchi of the right upper lobe in the patients were measured at the two periods, including indicators such as wall thickness (WT), thickness-diameter ratio (TDR), wall area (WA), percentage of wall area (WA%). The differences of those indicators at the two periods were compared with such factors of COPD comprehensive assessment as forced expiratory volume at the first second% (FEV1%), percentage of forced expiratory volume in first second to forced vital capacity (FEV1/FVC), COPD assessment test (CAT), modified medical research council questionnaire (mMRC) for assessing the severity of breathlessness, 6-minute walking distance (6MWD). Results The patients had significant differences between acute exacerbation period and remission period in the indicators of COPD comprehensive assessment like FEV1%, FEV1/FVC, CAT, mMRC and 6MWD (t=-4.119,-2.583, 4.012, 3.321 and-3.892,P<0.05). Compared with those at remission period, the WT, TDR, WA and WA% of sub-segmental bronchi were all higher at acute exacerbation period (t=3.025, 2.341, 2.204 and 2.124, P<0.05); only TDR of segmental bronchi showed significant difference between the two periods (t=2.990,P<0.05). The correlation of sub-segmental bronchi with FEV1%, FEV1/FVC, CAT, mMRC and 6MWD was more significant than that of segmental bronchi with those indicators at the two periods.Conclusion The COPD comprehensive assessment can help diagnose COPD at acute exacerbation period; MSCT shows the remodeling of segmental and sub-segmental bronchi and the changes on the airway wall, and the quantitative measurement of sub-segmental bronchi has correlation with the differences of indicators in the comprehensive assessment; COPD comprehensive assessment seems to be more valuable than PFT in the estimation of COPD at acute exacerbation.