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CT Assessment of Subtypes of Pulmonary Emphysema in Smokers^*

Katashi Satoh, MD; Takuya Kobayashi, MD; Takahiko Misao, MD; Yoshimi Hitani, MD; Yuka Yamamoto, MD; Yoshihiro Nishiyama, MD and Motoomi Ohkawa, MD

^* From the Department of Radiology (Drs. Satoh, Kobayashi, Yamamoto, Nishiyama, and Ohkawa), Kagawa Medical University, Kagawa, Japan; the Department of Respiratory Disease (Dr. Misao), Kagawa Prefectural Cancer Detecting Center, Kagawa, Japan; and the Department of Surgery (Dr. Hitani), Numakuma Hospital, Hiroshima, Japan. Presently at the Department of Radiology, KKR Takamatsu Hospital, Kagawa, Japan.

Correspondence to: Katashi Satoh, MD, 1750–1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan; e-mail: satoh{at}kms.ac.jp

Objective: To determine the incidence of subtypes of pulmonary emphysema (PE) identified by CT imaging in male patients who have a significant smoking history.

Patients and setting: We reviewed 945 subjects (619 men and 326 women) who had undergone CT scanning. However, only the data for male subjects were analyzed due to there being too few female subjects. The male subjects were divided into the following two age groups: group A (age, 50 years) and group B (> 50 years). There were two subtypes of PE found: centrilobular emphysema (CLE) and paraseptal emphysema (PSE). Based on these subtypes, PE was divided into the following three categories: I (CLE or CLE-predominant); II (CLE and PSE of equal extent); and III (PSE or PSE-predominant).

Results: PE was found in 270 of 516 male smokers (10 of 38 female smokers had PE). Among male subjects, in age group A there were 53 subjects with some degree of PE (category I, 12 subjects [22.6%]; category II, 7 subjects [13.2%]; and category III, 34 subjects [64.2%]). Among men in age group B, there were 217 subjects with some degree of PE (category I, 109 subjects [50.2%]; category II, 23 subjects [10.6%]; and category III, 85 subjects [39.2%]).

Conclusion: In age group A, men < 50 years of age who were in category III (PSE or PSE-predominant PE) predominated (34 of 53 subjects; 64.2%). In age group B, men > 50 years of age who were in category I (CLE or CLE-predominant PE) predominated (109 of 217 subjects; 50.2%).

Key Words: cigarette smoking • CT • emphysema • pulmonary

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