NAPCON, Pune
It was a unique and learning experience to talk of the role of HRCT in imaging of COPD and CTPA.
Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous lung condition characterized by airflow limitation, due emphysema or airway disease or variable combination of both.
Images for NAPCON, Pune Event
My talk was focussed on the role of Key roles of HRCT in COPD which are as discussed below:
- Disease Subtyping: HRCT allows differentiation between emphysema-predominant, airway-predominant, and mixed COPD types.
- Early Detection: HRCT can identify structural changes in subclinical cases.
- Complication Identification: HRCT helps detect complications such as pulmonary hypertension, infections or associated malignancies.
- Disease Quantification: HRCT enables objective assessment of COPD severity by quantifying parenchymal and airway involvement.
It was thus mutually agreed that HRCT is a valuable tool for diagnosing and subtyping COPD, as well as identifying complications and assessing disease severity. A systematic HRCT approach supports early detection, complication management, and phenotyping in COPD, contributing to improved patient outcomes.
The revolutionizing role of CT Pulmonary Angiography (CTPA) in evaluation of pulmonary vascular diseases, particularly pulmonary thromboembolism (PTE) was also discussed at length.
CTPA is a special time bound contrast CT chest study which with its high-resolution capabilities, allows for detailed assessment of the pulmonary vasculature and associated parenchymal changes, making it an indispensable tool in pulmonology.
1. Indications for CTPA
CTPA is primarily performed to confirm the presence of pulmonary thromboembolism in suspected cases, both acute and chronic.
Indications include:
- Moderate to High pretest probability of PTE
- Evaluation of pulmonary arterial hypertension (PAH)
- Assessment of complications from pulmonary vascular disorders, such as infarctions or secondary infections
- Preoperative evaluation in cases of chronic thromboembolic pulmonary hypertension (CTEPH)
CTPA is highly sensitive and specific for central PTE and offers valuable insights into the pulmonary vasculature and associated parenchymal abnormalities.
The role of using a proper protocol for accurate diagnosis was discussed. It was realised that these specialised tests are not simply performed by the machine on an algorithm but a proper protocol and the expertise of the man behind the machine is important to get the needed results.
