The recording of parenchymal lung changes in smokers by high-resolution computed tomography

Objective: It has been the aim of the study to assess parenchymal changes in the lung with high-resolution CT in healthy heavy, moderate, and non-smokers.

Methods: We prospectively evaluated CT changes in 42 healthy heavy smokers (gr. (group) 2, > or = 30 pack-years), 40 moderate smokers (gr. 1, < 30 pack-years) and 38 non-smokers (gr. 0). For CT-analysis, we used a visual grading and computer-based analysis system (Mipron, Kontron GmbH, Munich, Germany).

Results: Productive cough, dyspnoea and chronic bronchitis were more common in smokers than in non-smokers (p < 0.05). Pathological CT-findings were found in 6/38 non-smokers and in 71/82 smokers (p < 0.01). In particular, in smokers (gr. 1 [%], gr. 2 [%]) the following pathological findings were found: dystelectases in dependent lung areas in 50% (62, 38), centrilobular emphysema in 44% (43, 20), pleural thickening in 38% (38, 38), panlobular emphysema in 36% (52, 20), ground-glass pattern in 33% (36, 30), paraseptal emphysema in 21% (31, 10), prominent or thickened interlobular septa in 18% (29, 8) and centrilobular micronodules in 13% (10, 18). Computer-based analysis demonstrated thicker bronchial walls in smokers as compared to non-smokers.

Conclusions: Although feeling healthy, smokers demonstrate various parenchymal abnormalities in the lung. In smokers, subpleural dystelectases, centrilobular and panlobular emphysema are dependent on cigarette consumption, ground glass pattern, centrilobular micronodules, pleural thickening and bronchial wall thickening are independent on cigarette consumption.