title: Severe COPD exacerbation: CT features.
abstract: Abstract Objective: To describe CT features associated with severe exacerbations of Chronic Obstructive Pulmonary Disease (COPD).
  
  
  METHODS
  In this prospective ethical-committee-approved study, 44 COPD patients (34 men, 10 women, age range 49-83 years) who provided written informed consent were included at the time of hospital admission for severe exacerbation. Pulmonary function tests (PFT) and chest CT scans were performed at admission and after resolution of the episode following a minimum of 4 weeks free of any acute symptom. For each CT scan, two radiologists independently scored 15 features in each lobe and side. CT features and PFT results were compared for exacerbation and control through Mac-Nemar tests and paired t-tests, respectively.
  
  
  RESULTS
  Forced expiratory volume in 1 second and vital capacity improved significantly after exacerbation (p = 0.023 and 0.012, respectively). Bronchial wall thickening and lymphadenopathy were graded significantly higher at exacerbation than at control by both readers (p ranging from < 0.001 to 0.028). Other CT features were not observed during exacerbation, or were so only by one reader (p ranging from < 0.001 to 0.928).
  
  
  CONCLUSIONS
  Only lymphadenopathy and bronchial wall thickening are CT features associated with severe COPD exacerbation, respectively in 25% and 50% of patients. Our findings do not advocate a role for CT in the routine work-up of patients with severe COPD exacerbation.
authors.affiliation: 1Department of Radiology (MH, PAG), Hôpital Erasme, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Maxime
authors.initials: M
authors.lastname: Hackx
authors.forename: Benoît
authors.initials: B
authors.lastname: Ghaye
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Coche
authors.forename: Alain Van
authors.initials: AV
authors.lastname: Muylem
authors.forename: Pierre Alain
authors.initials: PA
authors.lastname: Gevenois
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012720:Severity of Illness Index; D016037:Single-Blind Method; D014797:Vital Capacity
keywords: bronchial wall; emphysema; lymphadenopathy; pulmonary embolism