X-ray-functional diagnostics of small and large airways damage in patients with community-acquired pneumonia

Aim: To assess the densitometric parameters of lung tissue indicative of small airway involvement and the morphometric parameters of large bronchi in patients with community-acquired pneumonia before and after treatment, and to analyze their diagnostic and clinical significance in comparison with spirometric parameters. Materials and methods. The authors analyzed CT and spirography data of 44 patients with community-acquired pneumonia before and after treatment with an interval of 10-14 days between the studies. Patients were divided into 2 groups according to the change in airflow according to the primary CT data. Lung function was assessed by forced expiratory flow spirometry. All examined patients underwent CT of lungs in the inspiratory phase with measurement of volumes in 3 density ranges, morphometric indices of large bronchi. Results. After the course of anti-inflammatory therapy there was a recovery of lung inflation in both groups. It was found that inflation was disturbed in both lungs, regardless of the localization of changes (unilateral, bilateral), which is associated with bronchial lesions. In the group with decreased inflation there was a positive correlation between the internal diameter of B10 of the right lung and forced expiratory volume in 1 sec (FEV₁ ) (r=0,51, p<0,0001), negative correlation - between the thickness of B10 wall of the right lung and FEV₁ (r=-0,53, p<0,0001). In the group of patients with lung hyperinflation, positive correlations were found between B10 inner diameter and FEV₁ (r=0,46, p=0,0001), between the index of inspiratory inflation and FEV₁ (r=0,80, p<0,0001). Conclusion. X-ray functional assessment of ventilation disorders by high-resolution CT with postprocessing allows to determine the type and reversibility of lung ventilation dysfunction and thereby significantly complement the visual characterization of lung lesions in community-acquired pneumonia.

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