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Airway Morphometry in COPD-Bronchiectasis Overlap
PP-PDPI, 09 Apr 2019 05:42:02

Abstract

Bronchiectasis is present in a subset of patients with COPD and diagnosed on the mid-airway generations by HRCT. It is currently not known what happens to the numbers and dimensions of the smaller airway generations in patients with COPD-related bronchiectasis.

Explant lungs of patients with COPD undergoing transplantation (n=14) and declined lungs of prospective donors (n=7) were collected. 5 donor, 5 COPD and 5 COPD-bronchiectasis lungs were inflated, frozen and scanned with HRCT (resolution 700 micrometer), of which images were used to count airway bifurcations and measure diameters. The remaining donor (n=2), COPD (n=2) and COPD-bronchiectasis (n=2) lungs were inflated, air-dried and scanned with microCT (resolution 80 micrometer) to quantify airway numbers and dimensions by airway segmentation.

Both COPD groups presented with a reduced number of airways compared to controls. A higher airway number and larger diameter per generation was present on HRCT images of COPD lungs with bronchiectasis compared to COPD lungs without bronchiectasis. Micro CT images of lung lobes confirmed more airways in lungs of COPD-bronchiectasis overlap compared to lungs with only COPD. Both number and diameter of airways was higher from the 7th generation onwards. This trend was more pronounced in the lower lobes, which generally showed more bronchiectasis.

These preliminary results show more and larger small airways in COPD lungs with bronchiectasis compared to COPD lungs without bronchiectasis.

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