Naveen Kulkarni MD, Presenter: Nothing to Disclose

Carl O'Donnell PhD, Abstract Co-Author: Nothing to Disclose

Alexander A. Bankier MD, Abstract Co-Author: Author with royalties, Reed Elsevier Consultant, Olympus Corporation

Mary E. Millett RN, Abstract Co-Author: Nothing to Disclose

Stephen Loring MD, Abstract Co-Author: Nothing to Disclose

Phillip M. Boiselle MD, Abstract Co-Author: Nothing to Disclose

With the routine use of thin-section MDCT scans, bronchial diverticula (BD) are increasingly recognized, but their prevalence and significance have not been fully determined. Our purpose is to compare the prevalence of BD between COPD patients and healthy volunteers (HVs) and to assess the relationship between BD and clinical and functional parameters in COPD patients

We prospectively studied 100 patients meeting GOLD criteria for COPD (mean age 65 ± 7 yrs) and 81 HVs with normal pulmonary function tests (PFTs) and no history of smoking (mean age 47 ± 17 yrs). Participants underwent 64-MDCT (40 mAs, 120 kVp, 0.625 mm collimation, reconstruction of 0.625 mm axial and coronal oblique images, and 2.5 mm MinIP coronal oblique reformations). Number, size (maximum diameter), and location of BD in the central airways (subcarinal or main bronchi) were recorded. COPD patients also underwent PFTs, a 6-minute walk test (6MWT), and a validated cough-specific quality of life questionnaire. Bronchial wall thickness (Pi10) and extent of emphysema (%LAA-950) were analyzed in a subset of 50 COPD participants using an automated software program (Pulmonary Workstation version 2.0, VIDA Diagnostics, Coralville, Iowa). Differences in proportions were compared by Χ2 and in means by the T-test.  

The prevalence of BD was 30% in HV and 28% in COPD patients (P=.81), and their mean size was 1.5 mm in HV and 1.4 mm in COPD patients (P=.82). No significant correlation between the number of BD and GOLD stage, pack yrs of smoking, FEV1, DLCO, cough severity, 6MWT distance, bronchial wall thickness, and extent of emphysema was found in COPD patients (all P values > 0.35).  

BD have a similar prevalence in COPD patients and healthy volunteers, without correlation to smoking or COPD severity.  

As an incidental finding on CT scans, radiologists should not attribute BD to smoking or COPD. 

Kulkarni, N, O'Donnell, C, Bankier, A, Millett, M, Loring, S, Boiselle, P, Bronchial Diverticula Detected by MDCT: Comparison between COPD Patients and Healthy Volunteers.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026361.html