Remy-Jardin et al studied the lungs of cigarette smokers with normal chest X-rays and pulmonary function tests using high resolution CT (HRCT). They were able to identify a number of findings that are seen in current or ex-smokers. The authors are from the University of Lille in Lille, France.
Imaging studies: high resolution CT
|
HRCT Finding |
Features |
|
parenchymal micronodules < 7 mm in diameter |
represent respiratory bronchiolitis; detected more often in the upper lung zones |
|
areas of ground-glass attenuation |
areas that are slightly hyperattenuated, with underlying vessels and bronchial walls still visible; represent areas of inflammation within the alveoli; detected more often in the upper lung zones |
|
emphysema |
areas of decreased attenuation and disruption of the vascular pattern, usually lacking a well-defined wall; detected more often in the upper lung zones |
|
dependent areas of attenuation |
seen in the posterior lung when supine but disappear when the patient is supine |
|
bronchial wall thickening |
central bronchus with wall thickness >= 2 times wall thickness of normal bronchus; peripheral bronchus with well-delineated bronchial walls |
|
septal lines |
thickened interlobular septa identified as fine linear areas of attenuation or as a polygonal pattern of multiple polygonal lines |
|
subpleural micronodules < 7 mm in diameter |
represent subpleural interstitial anthracosis |
where:
• Nodules >= 7 mm may be seen on routine chest X-ray.
• The patient should be in a typical state of health. Bronchopneumonia or other active lung infection would affect the findings.
Findings seen more commonly in smokers:
(1) ground glass attenuation
(2) emphysema
Findings seen more commonly in smokers or ex-smokers:
(1) parenchymal micronodules
(2) bronchial wall thickening
(3) dependent areas of attenuation
Findings seen in smokers, ex-smokers and non-smokers:
(1) subpleural micronodules
(2) septal lines
|
Changes on CT |
Nonsmokers |
Exsmokers |
Smokers |
|
normal CT |
57% |
37% |
17% |
|
1 or 2 CT changes |
38% |
50% |
50% |
|
>= 3 CT changes |
5% |
13% |
33% |
from Figure 5. page 113
Purpose: To evaluate a high resolution CT (HRCT) scan of the lungs for findings seen in smokers or exsmokers based on the study of Remy-Jardin et al.
Specialty: Pulmonology, Toxicology
Objective: imaging studies
ICD-10: X97,
