RadioGraphics 2010; 30:55-66
Shin Matsuoka, MD, PhD , TsuneoYamashiro, MD , George R. Washko, MD ,Yasuyuki Kurihara, MD, PhD ,Yasuo Nakajima, MD, PhD Hiroto Hatabu, MD, PhD
Chronic obstructive pulmonary disease (COPD) is characterized by the presence of airflow limitation that is caused by a combination of small airway remodeling and emphysema-induced loss of elastic re¬coil. The management of COPD depends on the relative distribution and severity of these two pathologic processes, factors that may vary widely even among patients with a similar degree of airflow limitation. Standard lung function testing with spirometry is unhelpful for distin¬guishing the specific contribution of each process. Pathologic changes such as emphysema and modification of the small and large airways are better evaluated with quantitative analyses of image data from multidetector computed tomography (CT). CT-based quantitative analyses can help differentiate the COPD phenotype (emphysema-predominant, airway-predominant, or mixed), which is crucial infor¬mation for determining the appropriate management strategy.