Influence of high-resolution computed tomography in reviewing the diagnosis of chronic obstructive pulmonary disease

Background and aim High-resolution computed tomography (HRCT) offers a more detailed anatomical assessment than the Chest radiography (CXR) in the diagnosis of chronic obstructive pulmonary disease (COPD). This study aimed to evaluate the influence of HRCT in refining the diagnosis and management of COPD patients. Patients and methods This study included 50 COPD patients. All patients underwent thorough clinical assessment, spirometry, CXR, and HRCT. HRCT findings were analyzed for emphysema, bronchial wall thickening, bronchiectasis, air trapping, and co-existing pathologies, and compared with CXR findings. Results The study included 45 males and five females, with a mean age of 63.32±10.45 years. Spirometry revealed various degrees of obstruction, with forced expiratory volume in 1 second (FEV1)% ranging from 12 to 75%. While CXR detected abnormalities in most patients (e.g. hyperinflation, increased bronchovascular markings), HRCT provided significantly more detailed information. HRCT identified emphysema in 72% of patients (centrilobular 46%, panlobular 26%), bronchial wall thickening in 90%, and bronchiectasis in 34%. Notably, HRCT revealed significant air trapping in 84%, cystic lung disease in 24%, and pulmonary nodules in 16%. HRCT also detected co-existing pathologies such as interstitial lung disease in 10% and pleural effusion in 6%. A statistically significant relationship was found between HRCT findings and CXR findings for consolidation or effusion ( P =0.001). Conclusion HRCT plays a valuable role in the comprehensive evaluation of COPD patients, offering superior anatomical detail compared with CXR. It is instrumental in detecting subtle parenchymal changes, airway abnormalities, and co-existing conditions that influence diagnosis and guide appropriate management, thereby improving patient outcomes.