Imaging Features of Chronic Bronchitis with Preserved Ratio and Impaired Spirometry (PRISm)
- 116 Downloads
The purpose of the study was to investigate the quantitative chest tomographic features of chronic bronchitis with preserved ratio and impaired spirometry (PRISm), including airway wall area, emphysema index, and lung capacity.
An observational, cross-sectional study of 343 patients at the Ninth Hospital of Xi’an Affiliated Hospital of Xi’an Jiaotong University between October 2014 and September 2017. The patients were divided into three groups: 77 cases of chronic bronchitis with normal lung function (forced expiratory volume in one second/forced vital capacity) (FEV1/FVC > 70%, FEV1%pred > 80%), 80 cases of chronic bronchitis with PRISm (FEV1/FVC > 70%, FEV1%pred < 80%), and 186 cases of the early chronic obstructive pulmonary disease (COPD) (FEV1/FVC < 70%, FEV1%pred > 50%, that is, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 1 + 2). We compared and analyzed the differences in imaging between the chronic bronchitis with PRISm and the other two groups.
Compared with the early COPD group, the PRISm group revealed significant differences in airway wall area, emphysema index, and lung capacity (P < 0.05). Compared with the chronic bronchitis with normal lung function group, the PRISm group showed increased WA%LUL5, decreased lung capacity, and higher mean lung density.
In terms of airway wall area and emphysema index, patients with chronic bronchitis with PRISm were essentially no different than those with chronic bronchitis without abnormal spirometry, whereas for symptoms, they are more like GOLD 1 and 2 patients. Our findings show that it is not yet clear whether it constitutes an intermediate stage of chronic bronchitis with normal lung function that progression to early COPD.
KeywordsChronic obstructive pulmonary disease Chronic bronchitis Preserved ratio and impaired spirometry Computed tomography Early diagnosis
This study was funded by the following grants: “Digital Lung” disease assessment system and diagnostic criteria (201402013) approved by the Chinese Society for Clinical Research; Award Number: ChiCTR-OCH-14004904 | Recipient: Youmin Guo, Clinical trial registration number: ChiCTR-OCH-14004904. The Social Development Science Research Project of Shaanxi Province; Award Number: No. 2016SF-151 | Recipient: Xia Wei. Xi’an Science and Technology Project; Award Number: 2016045SF / YX01 | Recipient: Xia Wei.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Vestbo J, Edwards LD, Scanlon PD, Yates JC, Agusti A, Bakke P, Calverley PM, Celli B, Coxson HO, Crim C, Lomas DA, MacNee W, Miller BE, Silverman EK, Tal-Singer R, Wouters E, Rennard SI, ECLIPSE Investigators (2011) Changes in forced expiratory volume in 1 second over time in COPD. N Engl J Med 365:1184–1192CrossRefGoogle Scholar
- 6.Wan ES, Castaldi PJ, Cho MH, Hokanson JE, Regan EA, Make BJ, Beaty TH, Han MK, Curtis JL, Curran-Everett D, Lynch DA, DeMeo DL, Crapo JD, Silverman EK, COPDGene Investigators (2014) Epidemiology, genetics, and subtyping of preserved ratio impaired spirometry (PRISm) in COPDGene. Respir Res 15:89CrossRefGoogle Scholar
- 11.Diaz AA, Strand M, Coxson HO, Ross JC, San Jose Estepar R, Lynch D, van Rikxoort EM, Rosas IO, Hunninghake GM, Putman RK, Hatabu H, Yen A, Kinney GL, Hokanson JE, Silverman EK, Crapo J, Washko GR (2017) Disease severity dependence of the longitudinal association between CT lung density and lung function in smokers. Chest 153:638–645CrossRefGoogle Scholar
- 23.McDonough JE, Yuan R, Suzuki M, Seyednejad N, Elliott WM, Sanchez PG, Wright AC, Gefter WB, Litzky L, Coxson HO, Paré PD, Sin DD, Pierce RA, Woods JC, McWilliams AM, Mayo JR, Lam SC, Cooper JD, Hogg JC (2011) Small-airway obstruction and emphysema in chronic obstructive pulmonary disease. N Engl J Med 365:1567–1575CrossRefGoogle Scholar