Computed Tomography Imaging Vessels, Airways and Emphysema: Association With Airflow Limitation in COPD

Parenchyma, airways and vessels are different compartments of the lung affected by chronic obstructive pulmonary disease (COPD). The impact of COPD on the parenchyma, known as emphysema, is characterized by tissue destruction, whereas disease in the airways and vessels manifests itself in terms of inflammation, structural remodelling/pruning. Emphysema has been shown to be associated with pruning of both airways and vessels and conventional measures of vascular remodelling may not be a sensitive measure of pruning/vessel loss because of proximal pruning of vessels resulting in their distal dilation. 

Therefore, this work focusses on development of a novel measurement of vascular loss, investigates the association between airway and vessel remodeling/loss and highlights relative contributions of different disease features towards airflow limitation in COPD. 

A significant association was found between measurements of airway and vascular pruning with our developed vascular measurement showing strongest association with airway measure, compared to the conventional measures of vascular loss, thus adding to its validity. Vascular alterations, airway remodelling and emphysematous destruction showed strongest relative association with airflow limitation in people who are at risk of developing COPD, mild COPD and moderate-severe COPD, respectively.