Radiation diagnostics of the state of ventilation and pulmonary circulation in patients with COPD

  • O. S. Sementsov State Institution «Zaporizhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
  • S. V. Stepanenko State Institution «Zaporizhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, Ukraine
Keywords: computed tomography, chronic obstructive pulmonary disease


COPD is one of the most common human diseases. WHO experts predict an increase in economic damage from COPD by 2020 and claim that they will rank first among respiratory diseases and third among all causes of death. In Ukraine, about 3 million people, or at least 7% of the population, suffer from COPD. The purpose of the study is to analyze the available literature sources to establish the current state of the problem of radiological diagnosis of COPD, to identify problematic issues. Based on the analysis of literature data, it can be concluded that for a comprehensive examination of patients with COPD or suspected COPD, and assessment of external respiration - clinical examination and spirometry, especially in the early stages of the disease - is not enough. It is believed that in the initial stages of COPD, when spirometry and clinical data do not reveal abnormalities, radiological diagnosis is more sensitive than functional tests. Among the modern methods of radiological diagnosis of lung diseases - the method of CT today is the most sensitive and specific method of detecting pathological changes in the lung parenchyma and respiratory tract, it is available and widely used in everyday practice. Also a promising area is the use of functional CT (inspiratory-expiratory CT) - which should improve the assessment of respiratory function, including early detection of patients with COPD, which will promote the in time start of specific treatment, reduce episodes of exacerbations during the disease, assess the dynamics of the pathological process and the effectiveness of treatment, as well as improving the prognosis of work and life expectancy of patients. However, given the lack of unifying works on the study of this method, further studies of the capabilities of computed tomography in the diagnosis of signs of dysfunction of external respiration in patients with COPD are required. First of all, further research is required on the distribution of air trap zones, especially in patients with emphysema, it is desirable that these future studies are not based only on the principle of visual assessment in the form of exclusion / confirmation of air trap zones.


Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. report 2021. 3–10.

Eisner MD, Anthonisen N, Coultas D [et al.]. An official American Thoracic Society public policy statement: novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2010; 182: 693–718.

Lamprecht B, McBurnie MA, Vollmer WM, [et al.]. BOLD Collaborative Research Group: COPD in never smokers: results form the population-based burden of obstructive lung disease study. Chest 2011; 139: 752–763.

Mehta AJ, Miedinger D, Keidel D, [et al.]. The SAPALDIA Team. Occupational exposure to dusts, gases, and fumes and incidence of chronic obstructive pulmonary disease in the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults. Am J Respir Crit Care Med 2012; 185: 1292–1300.

Saladin K. Human anatomy 3rd ed. McGraw- Hill; 2011. 650 p.

Global'naya iniciativa po Hronicheskoj Obstruktivnoj Bolezni Lyogkih (Global initiative for chronic Obstructive Pulmonary Disease). – Moskva: Atmosfera, 2003. – 96 p.

Leshchenko IV, Ovcharenko SI. Sovremennye problemy diagnostiki hronicheskoj obstruktivnoj bolezni lyogkih.Rossijskij medicinskij žurnal. 2003; 4(11) : 5–15.

Grippi MA. Patofiziologiya legkih. Moskva: Binom, X.: MTK-kniga. 2005; 304 39.

ZHestkov AV, Kosarev VV, Babanov SA. Hronicheskaya obstruktivnaya bolezn' legkih u zhitelej krupnogo promyshlennogo centra: epidemiologiya i faktory riska.Pul'monologiya. 2009; 6:53–57.

Tyurin IE. Vizualizaciya hronicheskoj obstruktivnoj bolezni legkih.Prakticheskaya pul'monologiya.2014; 2:40–46.

NICE Clinical Guideline. Chronic obstructive pulmonary disease in over 16s: diagnosis and management (NG 115). NICE (GB) – National Institute for Health and Clinical Excellence, 2018 Dec 5;P. 7–8; 52–53.

O'brien C, Guest PJ, Hill SL [et al.]. Physiological and radiological characterisation of patients diagnosed with chronic obstructive pulmonary disease in primary care. Thorax. 2000; 55 (8): 635–42.

Ozgun Niksarlioglu E, Aktürk Ü. Chest X-ray: is it still important in determining mortality in patients hospitalized due to chronic obstructive pulmonary diseases exacerbation in intensive care unit? Eurasian J Pulmonol. 2018; 20 (3): 133.

Takasugi JE, Godwin JD. Radiology of chronic obstructive pulmonary disease. Radiol. Clin. North Am. 1998; 36 (1): 29–55.

Nicklaus TM, Stowell DW, Christiansen WR [et al]. The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. Am Rev Respir Dis. 1966; 93 (6): 889–99.

Robertson RJ. Imaging in the evaluation of emphysema. Thorax. 1999; 54 (5): 379.

Galiè N, Torbicki A, Barst R [et al.]. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur. Heart J. 2004; 25 (24): 2243–78.

Lang IM, Plank C, Sadushi-Kolici R et al. Imaging in pulmonary hypertension. JACC Cardiovasc Imaging. 2010; 3 (12): 1287–95.

Maitre B, Similowski T, Derenne JP. Physical examination of the adult patient with respiratory diseases: Inspection and palpation. Eur Respir J. 1995; 8: 1584–93.

Kang E.Y.Radiology. 1995; 195(3). P. 649

Muller N.L., Miller R.R.Radiology. 1995;196:1. P. 3.

Todoriko LD. redactor Differencial'naya diagnostika osnovnyh sindromov pri zabolevaniyah organov dyhaniya i dopolnitel'nye materialy po ftiziatrii: Uchebnoe posobie. BGMU CHernovcy: Meduniversitet.2011. 320 p.

Todoriko LD redactor, Sem'yana IA,Shapovalov VP. Kliniko-rentgenologicheskij atlas po diagnostike zabolevanij legkih. CHernovcy: Meduniversitet, 2013. 342 p.

Semencov AS, Myagkov AP. Diagnosticheskie vozmozhnosti luchevyh funkcional'nyh issledovanij bol'nyh hronicheskimi nespecificheskimi zabolevaniyami legkih [dissertaciya]. 1992, Zaporozh'e, Ukraina.

Gorbunov NA. Funkcional'naya malodozovaya cifrovaya flyuorografiya dlya monitoringa effektivnosti terapii obostrenij hronicheskoj obstruktivnoj bolezni legkih. Sibirskij medicinskij zhurnal 2012;27:1:107–10.

Gorbunov NA, Laptev VYA, Kochura VI. i dr. Osobennosti luchevoj diagnostiki hronicheskoj obstruktivnoj bolezni legkih na sovremennom etape.Luchevaya diagnostika i terapiya.2011;4 (2):33–9.

Ujita M, Hansell DM. Small airway disease: detection and insights with computed tomographyM. Ujita,Eur. Respir. Monogr.2004;30:106–144

Kotlyarov PM. Mnogosrezovaya komp'yuternaya tomografiya legkih – novyj etap razvitiya luchevoj diagnostiki zabolevanij legkih. Medicinskaya vizualizaciya. 2011; (4): 14–20.

Prokop M. Spiral'naya i mnogoslojnaya komp'yuternaya tomografiya: Uchebn. posobie. V 2-h t.Medpress-inform. 2008. 416 p.

McDonough JE, Yuan R, Suzuki M [et al.]. Small-airway obstruction and emphysema in chronic obstructive pulmonary disease. N Engl J Med 2011, 365 (17): 1567–1575.

Hersh CP, Washko GR, Estépar RSJ, [et al.]. COPDGene Investigators: Paired inspiratory- expiratory chest CT scans to assess for small airways disease in COPD. Respir Res. 2013, 170: 301–7.

Verbanck S, Thompson BR, Schuermans D, [et al.]. Ventilation heterogeneity in the acinar and conductive zones of the normal ageing lung. Thorax 2012, 67 (9): 789–795.

Burgel PR: The role of small airways in obstructive airway diseases. Eur Respir Rev 2011; 20 (119): 23–33.

Austin JH, Müller NL, Friedman PJ et al. GlossaryoftermsforCTofthelungs:recommendations of the Nomenclature Committee of the Fleischner Society. Radiology. 1996; 200 (2): 327–31.

Tanaka N, Matsumoto T, Miura G [et al.]. Air trapping at CT: high prevalence in asymptomatic subjects with normal pulmonary function. Radiology. 2003; 227 (3): 776–85.

Amato M, Larici AR, Ciello A [et al.]. Inspiratory and expiratory MDCT (multidetector computed tomography) scans: automatic airways analysis in patients with chronic obstructive pulmonary disease (COPD).Insights into Imaging.2011;2(1):64–65.

Calvin YWH, Gladys GL Xenon ventilation CT scan demonstrates an increase in regional ventilation after bullectomy in a COPD patient.Somatom. Sessions. 2010;27:64–65.

Kauczor HU, Hast J., Heussel CP [et al.]. CT attenuation of paired HRCT scans obtained at full inspiratory/expiratory position: comparison with pulmonary function testsEur. Radiol.2002;12(11): 2757–63.

Camp PG, Ramirez-Venegas A, Sansores RH, [et al.]. COPD phenotypes in biomass smoke-versus tobacco smoke-exposed Mexican women. Eur Respir J 2014; 43: 725–34.

Lee KW, Chung SY, Yang I, [et al.]. Correlation of aging and smoking with air trapping at thin- section CT of the lung in asymptomatic subjects. Radiology. 2000; 214: 813–36.

Mets OM, Zanen P, Lammers JW, [et al.]. Early identification of small airways disease on lung cancer screening CT: comparison of current air trapping measures. Lung 2012; 190: 629–33.

Sébastien B, Grégory M, Arnaud B, [et al.]. Relationship between CT air trapping criteria and lung function in small airway impairment quantification. BMC Pulmonary Medicine. 2014;14,: 29,

Karimi R, Tornling G, Forsslund H, [et al.]. Differences in regional air trapping in current smokers with normal spirometry. Eur Respir J. 2017. 49 p.

Hashimoto M, Tate E, Watarai J, [et al.]. Air trapping on computed tomography images of healthy individuals: effects of respiration and body mass index. Clin Radiol 2006; 61: 883–7.

Mastora I, Remy-Jardin M, Sobaszek A, [et al.]. Thin-section CT finding in 250 volunteers: assessment of the relationship of CT findings with smoking history and pulmonary function test results. Radiology 2001; 218: 695–702.

Tanaka N, Matsumoto T, Miura G, [et al.]. Air trapping at CT: high prevalence in asymptomatic subjects with normal pulmonary function. Radiology 2003; 227: 776–85.

Galbán CJ, Han MK, Boes JL, [et al.]. Computed tomography-based biomarker provides unique signature for diagnosis of COPD phenotypes and disease progression. Nat Med 2012; 18: 1711–15.

Bhatt SP, Soler X, Wang X, [et al.]. Association between functional small airway disease and FEV1 decline in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2016; 194: 178–84.

Hoff BA, Pompe E, Postma DS, [et al.]. Morphological features of non-emphysematous obstruction in COPD. Am J Respir Crit Care Med 2016; 193.

PRIKAZ № 555 Ministerstva zdravoohraneniya Ukrainy ot 27.06.2013. Ob utverzhdeniiivnedreniemediko-tekhnologicheskih dokumentov po standartizacii medicinskoj pomoshchi pri hronicheskom obstruktivnom zabolevanii legkih. [Internet] URL https://zakononline.com.ua/documents/show/47081___486821

How to Cite
Sementsov, O. S., & Stepanenko, S. V. (2022). Radiation diagnostics of the state of ventilation and pulmonary circulation in patients with COPD. Modern Medical Technology, (1(52), 71-78. https://doi.org/10.34287/MMT.1(52).2022.12