Radiographic appearance of the chest in emphysema.

Accuracy of the radiologic diagnosis of emphysema was assessed in 696 patients from whose lungs paper-mounted whole-lung sections had been made. Emphysema was diagnosed radiographically primarily on the basis of arterial deficiency. In addition, lung length, lung width, size of the retrosternal space, heart size, and diaphragm position were recorded from the chest films. Recognition of emphysema was poor when radiographs of inadequate quality were included (anteroposterior films or films from patients with acute or chronic lung disease). When these films were excluded, only occasional radiographs from patients without emphysema or with mild emphysema were thought to have emphysema radiologically. Of the patients with moderately severe and severe emphysema, 41% were diagnosed as having emphysema, as were two-thirds of those with the most severe grade of emphysema. For a given grade of emphysema, the radiologic diagnosis of emphysema was made more frequently when patients had severe chronic airflow obstruction. Emphysema was usually most severe in the zones of the lung in which emphysema was radiologically apparent. Centrilobular emphysema was usually present when emphysema was diagnosed radiologically in the upper zones of the lung, and panacinar emphysema was usually present when emphysema was diagnosed in the lower zones. Lung length and the size of the retrosternal space increased, the level of the diaphragm lowered, heart size decreased, and lung width was unchanged as emphysema became more severe. Lung length and diaphragm level were the most discriminating measurements, followed by size of the retrosternal space. No combination of radiologic variables was found that recognized emphysema better than the subjective diagnosis of emphysema based on arterial deficiency. Radiologic lung dimensions are related to stature; for given stature these measurements are larger in men and women.

[1]  E. M. Mcfl.  PRICE'S TEXTBOOK OF THE PRACTICE OF MEDICINE , 1957, The Ulster Medical Journal.

[2]  I. Grant.  Chronic Airflow Obstruction in Lung Disease , 1977 .

[3]  Jerome L. Martin,et al.  Respiratory Function in Disease , 1972 .

[4]  J M Tanner,et al.  Growth of Radiologically Determined Heart Diameter, Lung Width, and Lung Length from 5-19 Years, with Standards for Clinical Use , 1972, Archives of disease in childhood.

[5]  L. North,et al.  Lung recoil pressure, airway resistance, and forced flows related to morphologic emphysema. , 2015, The American review of respiratory disease.

[6]  W M Thurlbeck,et al.  A comparison of three methods of measuring emphysema. , 1970, Human pathology.

[7]  R. G. Fraser,et al.  A COMPARISON BETWEEN CLINICAL, ROENTGENOLOGIC, FUNCTIONAL AND MORPHOLOGIC CRITERIA IN CHRONIC BRONCHITIS, EMPHYSEMA, ASTHMA AND BRONCHIECTASIS , 1970 .

[8]  C. Martin,et al.  The roenrgenologic diagnosis of anatomic emphysema. , 1967, The American review of respiratory disease.

[9]  Thurlbeck Wm.  The geographic pathology of pulmonary emphysema and chronic bronchitis. II. Subjective assessment of emphysema. , 1967 .

[10]  D. Stowell,et al.  The accuracy of the roentgenologic diagnosis of chronic pulmonary emphysema. , 1966, The American review of respiratory disease.

[11]  C M Fletcher,et al.  The emphysematous and bronchial types of chronic airways obstruction. A clinicopathological study of patients in London and Chicago. , 1966, Lancet.

[12]  L. Reid.  The pathology of emphysema. , 1966, Postgraduate medicine.

[13]  P. Pratt,et al.  ROENTGENOLOGIC CRITERIA FOR THE RECOGNITION OF NONSYMPTOMATIC PULMONARY EMPHYSEMA. CORRELATION BETWEEN ROENTGENOLOGIC FINDINGS AND PULMONARY PATHOLOGY. , 2015, The American review of respiratory disease.

[14]  F. Millard,et al.  CORRELATION BETWEEN RADIOLOGICAL DIAGNOSIS AND STRUCTURAL LUNG CHANGES IN EMPHYSEMA. , 1964, Clinical radiology.

[15]  M. Daves.  Principles of Chest X-ray Diagnosis , 1957 .

[16]  J. Gough,et al.  Thin sections of entire organs mounted on paper. , 1957, Harvey lectures.