Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Astım ve Kronik Obstrüktif Akciğer Hastalığında Yüksek Rezolüsyonlu Bilgisayarlı Tomografi Bulguları ile Solunum Fonksiyon Testlerinin Karşılaştırılması
Comparison of High Resolution Computerized Tomography Findings and Respiratory Function Tests in Asthma and Chronic Obstructive Pulmonary Disease
Hakan BAHADIRa
aBetatom Emar Bahçelievler Görüntüleme Merkezi, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Sci. 2020;40(2):183-7
doi: 10.5336/medsci.2019-72459
Article Language: TR
Full Text
ÖZET
 Amaç: Son yıllarda gelişen yüksek rezolüsyonlu bilgisayarlı tomografi (YRBT), parankimal akciğer hastalıklarının görüntülenmesinde yeni bir dönem açmıştır. Çalışmada, kronik inflamasyon ve obstrüktif ventilasyon bozukluğu yapan 2 akciğer hastalığı; astım ve kronik obstrüktif akciğer hastalığı (KOAH)'nda YRBT bulguları ve solunum fonksiyon parametreleri irdelenerek her 2 hastalık için YRBT bulguları ile fonksiyonel parametrelerin uyumu ortaya konmak istenmiştir. Gereç ve Yöntemler: 1998-2000 yılları arasında İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Göğüs Hastalıkları Ana Bilim Dalı'nda takip edilen, stabil durumdaki sigara içmemiş 29 astımlı ve 20 KOAH'lı hastaya Radyoloji ana bilim dalımızda YRBT incelemesi gerçekleştirildi. Her hastanın YRBT incelemesi ile aynı günde solunum fonksiyon testleri gerçekleştirildi. Bulgular: YRBT incelemelerinde KOAH'lı 6 hastada bronş duvarı kalınlaşması, 8 hastada tübüler bronşektaziler, 12 hastada amfizem, 2 hastada dallanan tübüler yapılar ve 1 hastada hava hapsi saptadık. Yirmi dokuz astımlı hastanın YRBT incelemesinde ise 8 hastada tübüler bronşektazi, 12 hastada bronş duvarı kalınlaşması, 4 hastada amfizem, 6 hastada hava hapsi ve 1 hastada atelektazi saptadık. Çalışmamızda, 2 hastalık arasında amfizem sıklığının KOAH'lılarda daha fazla olduğunu tespit ettik. Astımlılarda FEV1/FVC, FEF25-75 ve %FEF25-75, %DLCO, %DLCO/VA ortalama değerleri KOAH'lılara göre anlamlı derecede daha yüksek saptandı. Sonuç: Yaptığımız çalışmada, KOAH ve astımda saptanan YRBT bulgularının istatistiksel benzerlikleri ve amfizem dışında farklılık olmaması sebebi ile hasta sayısı az olduğundan, sensitivite ve spesifisite belirlenememiş olsa da ayırıcı tanıda YRBT'nin spesifik olmadığı, amfizem parametresinde bu 2 hastalığı ayırmada önem taşımadığı kanısına varılmıştır.

Anahtar Kelimeler: Astım; KOAH; bilgisayarlı tomografi; solunum fonksiyon testi
ABSTRACT
 Objective: In recent years, high resolution computed tomography (HRCT) has opened a new era in the imaging of parenchymal lung diseases. In this study, HRCT findings and pulmonary function parameters in asthma and chronic obstructive pulmonary disease (COPD) with chronic inflammation and obstructive ventilation disorder were examined and the findings of HRCT findings and functional parameters were compared for both diseases. Material and Methods: HRCT was performed in 29 non-smoking asthmatic and 20 COPD patients who were followed up in Istanbul University Cerrahpaşa Medical Faculty Chest Diseases Department between 1998-2000. Pulmonary function tests were performed on the same day with HRCT examination. Results: HRCT examinations revealed bronchial wall thickening in 6 patients, tubular bronchiectasis in 8 patients, emphysema in 12 patients, branching tubular structures in 2 patients, and air trapping in 1 patient. HRCT examination of 29 asthmatic patients revealed tubular bronchiectasis in 8 patients, bronchial wall thickening in 12 patients, emphysema in 4 patients, air trapping in 6 patients, and atelectasis in 1 patient. In our study, we found that the prevalence of emphysema was higher in COPD patients between the two diseases. We found that FEV1/FVC, FEF25-75% and FEF25-75%, DLCO, % DLCO/VA mean values were significantly higher in patients with asthma than COPD patients. Conclusion: In our study, HRCT findings in COPD and asthma were similar and there was not any difference due to statistical similarities and emphysema except sensitivity and specificity.

Keywords: Asthma; COPD; computed tomography; pulmonary function test
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