Imagerie dans la broncho-pneumopathie chronique obstructive (BPCO)

The diagnosis and follow-up of chronic obstructive pulmonary disease (COPD) is based mainly on clinic and plethysmography. However, imaging techniques remain an indispensable exploration for differential diagnosis with other diseases and in detecting complications of COPD. Chest radiography of patients with COPD is usually normal, especially in early stage of disease. However, in 20% to 40% of cases, some radiographic abnormalities might be detected. These images are due to the thickening of entire tissue surrounding the bronchi caused by chronic inflammatory state. Chest radiography may be more valid in the advanced stages of the disease, accompanied by bronchial obstruction. Tomodensitometry might determine accurately the existence of emphysematous cysts, dilatation of pulmonary arteries and bronchi, and bronchial infections. This method allows to visualize directly the damaged lung areas and detect emphysema much better than conventional chest radiography. The tomodensitometry technique also allows to accurately assess degree of expansion of emphysema.