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Quantitative computed tomography features and clinical manifestations associated with the extent of bronchiectasis in patients with moderate-to-severe COPD

Authors Bak SH, Kim SH, Hong Y, Heo J, Lim MN, Kim WJ

Received 23 November 2017

Accepted for publication 19 February 2018

Published 1 May 2018 Volume 2018:13 Pages 1421—1431

DOI https://doi.org/10.2147/COPD.S157953

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell


So Hyeon Bak,1 Soohyun Kim,2 Yoonki Hong,3 Jeongwon Heo,4 Myoung-Nam Lim,5 Woo Jin Kim3

1Department of Radiology, School of Medicine, Kangwon National University, Chuncheon, Repubilc of Korea; 2Department of Radiology, Kangwon National University Hospital, Chuncheon, Republic of Korea; 3Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Republic of Korea; 4Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Republic of Korea; 5Data Analysis Center, Kangwon National University, Chuncheon, Republic of Korea

Background: Few studies have investigated the quantitative computed tomography (CT) features associated with the severity of bronchiectasis in COPD patients. The purpose of this study was to identify the quantitative CT features and clinical values to determine the extent of bronchiectasis in moderate-to-severe COPD patients.
Methods: A total of 127 moderate-to-severe COPD patients were selected from the cohort of COPD in Dusty Areas (CODA). The study subjects were classified into three groups according to the extent of bronchiectasis on CT: no bronchiectasis, mild bronchiectasis, and moderate-to-severe bronchiectasis. The three groups were compared with respect to demographic data, symptoms, medical history, serum inflammatory markers, pulmonary function, and quantitative CT values.
Results: Among 127 moderate-to-severe COPD subjects, 73 patients (57.5%) were detected to have bronchiectasis, 51 patients (40.2%) to have mild bronchiectasis, and 22 patients (17.3%) to have moderate-to-severe bronchiectasis. Compared with COPD patients without bronchiectasis, those with bronchiectasis were older and had higher frequency of prior tuberculosis, lower prevalence of bronchodilator reversibility (BDR), and more severe air trapping (P < 0.05). Moderate-to-severe bronchiectasis patients had lower body mass index (BMI), higher frequency of prior tuberculosis, lower prevalence of BDR, worse pulmonary function, and more severe air trapping (P < 0.05) than those in the mild bronchiectasis group.
Conclusion: Moderate-to-severe bronchiectasis was associated with a history of pulmonary tuberculosis, lower BMI, severe airflow obstruction, and lower BDR in moderate-to-severe COPD patients. Quantitative analysis of CT showed that severe air trapping was associated with the extent of bronchiectasis in these patients.

Keywords: chronic obstructive pulmonary disease, bronchiectasis, computed tomography, air trapping, tuberculosis

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