Özlem ÖZKALE YAVUZ, Koray HEKİMOGLU, Mehmet COSKUN, Gaye ULUBAY, M. Şule AKÇAY, Alev DOLU, A. Muhtesem AGILDERE

Ağır Sigara İçicilerde Yüksek Çözünürlüklü Bilgisayarlı Tomografi Bulguları ve Solunum Fonksiyon Testleri ile Korelasyonu

Giriş: Göğüs radyografileri ve solunum fonksiyon testleri (SFT), sigaranın akciğerler üzerindeki olumsuz etkilerini gösterebilir, ancak bazı durumlarda bu yöntemler yetersiz kalır ve tetkikler normal olarak yorumlanır. Yüksek çözünürlüklü bilgisayarlı tomografi (YRBT), sigaraya bağlı akciğer hastalıklarının erken evrelerinde parankimal-interstisyel anormallikleri belirlemek için daha hassas ve spesifik görüntüleme özellikleri sağlar. Bu çalışmanın amacı, sigara içen ve içmeyenlerde akciğer YRBT bulgularını tanımak ve SFT'lerinde tanımlanan hava yolu obstrüksiyonu ile bir ilişkisi olup olmadığını araştırmaktır. Yöntemler: Çalışmaya hem toraks YÇBT hem SFT tetkikleri mevcut 155 olgu (110 ağır sigara içicisi, 45 sigara içmeyen) dahil edildi. Toraks YÇBT incelemesi, nodüller, bronşektazi, bronşiyal duvar kalınlaşması, amfizem, atelektazi, buzlu cam alanları, interstisyel paternler ve fibrotik değişiklikler açısından, iki deneyimli radyolog tarafından bağımsız olarak değerlendirildi. Daha sonra ağır sigara içicilerin ve sigara içmeyenlerin YÇBT bulguları ile SFT arasındaki ilişki istatistiksel olarak sunuldu. Bulgular: Ağır sigara içenler ve içmeyenler arasında amfizem ve bronşiyal duvar kalınlaşması açısından YRBT'de istatistiksel olarak anlamlı farklar vardı (sırasıyla p = 0,001 ve p = 0,000). Amfizem ve bronşiyal duvar kalınlaşması, obstrüktif SFT değerlerine sahip hastalarda daha sık görülüyordu. Fibrotik değişiklikler, atelektazi, bronşiyal duvar kalınlaşması ve amfizem normal SFT değerlerine rağmen en sık görülen görüntüleme bulgularıydı. Sonuç: Sigaraya bağlı akciğer hastalığının tanı ve tedavisi için ağır sigara içicilerinin toraks YÇBT'lerinde en sık görülen görüntüleme bulgularının tanınması çok önemlidir. HRCT, normal göğüs radyogramları ve normal SFT değerlerine rağmen, sigaraya bağlı akciğerlerde görülebilecek parankimal-interstisyel anormallikleri erken evrede yakalamada hayati öneme sahiptir.

Anahtar Kelimeler:

Toraks YÇBT, solunum fonksiyon testi, sigara içicisi, amfizem

High-resolution computed tomography findings in healthy heavy smokers and correlation with pulmonary function tests

Introduction: Chest radiographs and pulmonary function tests (PFTs), may show the adverse effects of smoking on the lungs, but in some cases these methods are inadequate and interpreted as normal. High-resolution computed tomography (HRCT) provides more sensitive and specific imaging features to identify parenchymal-interstitial abnormalities in the early stages of the disease related with smoking. The purpose of this study is to recognize lung HRCT findings of smoking in cigarette smokers and non-smokers and investigate whether there is a relationship with airway obstruction on PFTs. Methods: A total of 155 subjects (110 heavy smokers, 45 non-smokers) who performed both HRCT and PFTs were included in the study. Two radiologists independently evaluated the CT findings for the following characteristics: bronchiectasis, bronchial wall thickening, emphysema, atelectasis, interstitial patterns, and fibrotic changes. Afterwards, the relationship between the HRCT findings and PFTs of the heavy smokers and non-smokers was presented statistically. Results: There were statistically significant differences regarding emphysema and bronchial wall thickening between the heavy smokers and non-smokers (p = 0.001 and p = 0.000, respectively) on HRCT. Emphysema and bronchial wall thickening were more common in patients who had obstructive PFTs. Fibrotic changes, atelectasis, bronchial wall thickening, and emphysema were the most common imaging findings although normal PFTs. Conclusion: It is crucial to recognize the common imaging findings on HRCT of heavy smokers for diagnosis and treatment of smoking related lung disease. HRCT is vital in detecting the early stages of parenchymal-interstitial abnormalities of the lungs due to smoking, despite normal chest radiograms and PFTs.

Keywords:

Thorax HRCT, pulmonary function tests, smoker, emphysema,

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