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Chronic Obstructive Pulmonary Diseases:
Journal of the COPD Foundation Original Research.
Visual Assessment of CT Findings in Smokers With Nonobstructed Spirometric Abnormalities in The COPDGene® Study Song Soo Kim, MD,1,2 Kunihiro Yagihashi, MD,1 Douglas S. Stinson, MS,1 Jordan A. Zach BA,1 Alexander S. McKenzie BA,1 Douglas Curran-Everett, PhD,3 Emily S. Wan, MD,4 Edwin K. Silverman, MD, PhD,4 James D. Crapo, MD,5 David A. Lynch, MB1
Abstract WithintheCOPDGeneticEpidemiology(COPDGene®)studypopulationofcigarettesmokers,9%werefoundto beunclassifiablebytheGlobalInitiativeforchronicObstructiveLungDisease(GOLD)criteria.Thisstudywasto identifythedifferencesincomputedtomography(CT)findingsbetweenthisnonobstructed(GOLDU)groupand acontrolgroupofsmokerswithnormallungfunction.Thisresearchwasapprovedbytheinstitutionalreviewboardof eachinstitution.CTimagesof400participantsintheCOPDGene®study(200GOLDU,200smokerswithnormal lungfunction)wereretrospectivelyevaluatedinablindedfashion.VisualCTassessmentincludedlobaranalysis ofemphysema(type,extent),presenceofparaseptalemphysema,airwaywallthickening,expiratoryairtrapping, centrilobularnodules,atelectasis,non-fibroticandfibroticinterstitiallungdisease(ILD),pleuralthickening,diaphragmatic eventration,vertebralbodychangesandinternalthoracicdiameters(inmm).Univariatecomparisonsofgroupsfor eachCTparameterandmultiplelogisticregressionwereperformedtodeterminetheimagingfeaturesassociatedwith GOLDU.Whencomparedwiththecontrolgroup,GOLDUparticipantshadasignificantlyhigherprevalenceofunilateral diaphragmeventration(30%vs.16%),airwaywallthickening,centrilobularnodules,reticularabnormality,paraseptal emphysema(33%vs.17%),linearatelectasis(60%vs.35.6%),kyphosis(12%vs.4%),andasmallerinternaltransverse thoracicdiameter(255±22.5[standarddeviation]vs.264.8±22.4,mm)(allp