Classification of chronic obstructive pulmonary disease based on chest radiography

Abstract

Objective: Quantitative analysis of chest radiographs of patients with and without chronic obstructive pulmonary disease (COPD) determining if the data obtained from such radiographic images could classify such individuals according to the presence or absence of disease. Materials and Methods: For such a purpose, three groups of chest radiographic images were utilized, namely: group 1, including 25 individuals with COPD; group 2, including 27 individuals without COPD; and group 3 (utilized for the reclassification/validation of the analysis), including 15 individuals with COPD. The COPD classification was based on spirometry. The variables normalized by retrosternal height were the following: pulmonary width (LARGP); levels of right (ALBDIR) and left (ALBESQ) diaphragmatic eventration; costophrenic angle (ANGCF); and right (DISDIR) and left (DISESQ) intercostal distances. Results: As the radiographic images of patients with and without COPD were compared, statistically significant differences were observed between the two groups on the variables related to the diaphragm. In the COPD reclassification the following variables presented the highest indices of correct classification: ANGCF (80%), ALBDIR (73.3%), ALBESQ (86.7%). Conclusion: The radiographic assessment of the chest demonstrated that the variables related to the diaphragm allow a better differentiation between individuals with and without COPD.Objetivo: O estudo avalia, quantitativamente, as radiografias torácicas de indivíduos com e sem doença pulmonar obstrutiva crônica (DPOC) e verifica se dados obtidos da imagem radiográfica podem classificar o indivíduo em com e sem DPOC. Materiais e Métodos: Utilizaram-se três grupos de imagens radiográficas torácicas: grupo 1, com 25 indivíduos com DPOC; grupo 2, com 27 indivíduos sem DPOC; grupo 3 (utilizado na reclassificação/validação da avaliação), com 15 indivíduos com DPOC. A classificação da DPOC tomou como base a espirometria. As variáveis utilizadas, normalizadas pela altura retroesternal, foram: largura pulmonar (LARGP), níveis de rebaixamento diafragmático direito (ALBDIR) e esquerdo (ALBESQ), ângulo costofrênico (ANGCF) e distâncias intercostal direita (DISDIR) e esquerda (DISESQ). Resultados: Na comparação das radiografias de indivíduos com DPOC e sem DPOC houve diferença estatística entre os dois grupos nas variáveis relacionadas com o diafragma. Para a reclassificação da DPOC, apresentaram maior índice de classificação correta: ANGCF (80%), ALBDIR (73,3%), ALBESQ (86,7%). Conclusão: A avaliação do tórax por meio de imagens radiológicas demonstrou que as variáveis que permitem uma maior discriminação entre indivíduos com e sem DPOC são aquelas relacionadas ao músculo diafragmático. Unitermos: Doença pulmonar obstrutiva crônica; Classificação da DPOC; Radiografia de tórax. Abstract Resumo * Study developed at Pontifícia Universidade Católica do Paraná (PUCPR) -Post-graduation Program in Health Technology,

Can chest high-resolution computed tomography findings diagnose pulmonary alveolar microlithiasis?

“…With the progression of the disease, which generally takes 10 to 20 years, cyanosis and digital clubbing are commonly observed. Dyspnea is the most frequent symptom, followed by dry coughing, chest pain, hemoptysis and asthenia, besides possible occurrence of pneumothorax ( 2 , 10 , 22 - 24 ) . Progressive deterioration of the pulmonary function may occur in adults, and death generally occurs in mid-adulthood because of respiratory failure with cor pulmonale ( 14 ) .…”