Quantitative Radiological Anatomy of Pulmonary Parenchyma in Chronic Obstructive Pulmonary Disease: A High-Resolution Ct Based Morphometric Study

Abstract

Objective: To evaluate the quantitative radiological anatomy of the pulmonary parenchyma in COPD using HRCT-based morphometric analysis.

Materials and Methods: This cross-sectional study included 60 clinically stable COPD patients aged 40–80 years. HRCT scans were performed using a standardized protocol during full inspiration. Quantitative parameters assessed included bronchial wall thickness and luminal diameter of bronchi, mean lung density (MLD), low attenuation areas (LAA < −950 HU), emphysema index (EI), total lung volume (TLV) and zonal distribution of disease. Data were analyzed using statistical softwareand correlations between variables were determined.

Results: The mean age of patients was 61.4 ± 9.2 years, with a predominance of males (70%). Bronchial wall thickness was increased (2.8 ± 0.6 mm) while luminal diameter was reduced (4.9 ± 1.1 mm). Mean lung density was decreased (−856.3 ± 34.5 HU)and low attenuation areas constituted 28.7 ± 10.2% of lung volume. The emphysema index was 30.2 ± 11.5% and total lung volume was elevated (5890 ± 820 mL), indicating hyperinflation. Zonal analysis showed a predominance of disease in the upper lung regions. Significant correlations were observed between emphysema index and mean lung density (r = −0.72, p < 0.001) as well as total lung volume (r = 0.64, p < 0.001).

Conclusion: HRCT-based quantitative analysis provides a comprehensive and objective evaluation of structural lung changes in COPD. The combined assessment of airway and parenchymal parameters enhances understanding of disease severity and distribution, supporting its role in improved diagnosis, phenotyping and management of COPD.