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Longitudinal Follow-up Study of Smoker’s Lung with Thin-Section CT in Correlation with Pulmonary Function Tests¹

¹ From the Department of Radiology, Calmette University Center Hospital, Blvd Jules Leclerc, 59037 Lille, France (M.R.J., J.R., I.M.); the Medical Research Group, Equipe d’Accueil no. 2682, Lille, France (M.R.J., J.R.); and the Environmental and Occupational Health and Ergonomics Research Center, University of Lille, France (J.L.E., C.B., A.S.). From the 2000 RSNA scientific assembly. Received June 30, 2000; revision requested August 28; revision received April 23, 2001; accepted May 22. Address correspondence to M.R.J. (e-mail: mremy-jardin@chru-lille.fr).

PURPOSE: To evaluate thin-section computed tomography (CT) in depicting longitudinal changes in the lung parenchyma.

MATERIALS AND METHODS: One hundred eleven volunteers underwent sequential examination with thin-section CT and pulmonary function tests over a mean period of 5.5 years. According to their smoking habits between initial evaluation (T0) and follow-up (T1), the subjects were classified as persistent current smokers (n = 57), persistent nonsmokers (n = 31), persistent ex-smokers (n = 13), or quitters (n = 10).

RESULTS: Significant differences in CT findings between T0 and T1 were seen in only the group of persistent current smokers, who showed a higher frequency of emphysema (40% vs 26%; P = .005) and ground-glass attenuation (42% vs 28%; P = .02). Individual analysis of follow-up CT scans in the 19 persistent current smokers with micronodules at T0 demonstrated (a) no changes in seven cases, (b) a higher profusion of micronodules in seven cases, and (c) replacement of micronodules with emphysema in five cases. Subjects with emphysema and/or areas of ground-glass attenuation at T0 had a significantly more rapid decline in lung function than did those with a normal CT scan.

CONCLUSION: Emphysema and/or ground-glass attenuation are linked with impairment of ventilatory lung function over time in persistent current smokers.

Index terms: Bronchiolitis, 60.2191 • Computed tomography (CT), high resolution, 60.12118 • Emphysema, 60.75 • Lung, diseases, 60.75, 60.2191 • Lung, function, 60.75, 60.2191

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