Role of chest radiograph in the diagnosis of chronic obstructive pulmonary disease

The article was professionally consulted with Master, Doctor Trinh Van Dong - Radiologist - Department of Diagnostic Imaging - Vinmec Ha Long International Hospital.

Although X-ray is not a standard for diagnosing chronic obstructive pulmonary disease (COPD), it is a simple, non-invasive method that helps orient the diagnosis, stage diagnosis and especially helps distinguish symptoms from other diseases.

Chronic obstructive pulmonary disease (COPD) is preventable and treatable if detected early. The disease is characterized by persistent and often progressive airflow limitation. Associated with a chronic inflammatory response in the airways and lungs to noxious gases or particles.
COPD is a serious impairment of respiratory function and the 3rd leading cause of death and disability globally, COPD tends to increase due to its association with heavy smoking and increased life expectancy high. This is an irreversible condition so an accurate and timely diagnosis is very important for early treatment of COPD.
Causes and risk factors for the disease:
Predisposing factors: Genetics, increased airway reactivity to agents, abnormalities in lung maturation. Smoke. Indoor and outdoor air pollution. Exposure to occupational dust and chemicals (including vapors, irritants, and fumes). Respiratory infection. Clinical signs of the disease:
Cough lasts, increasing gradually over time. Chronic sputum production, the level of sputum gradually increases over time. Chest tightness, shortness of breath on exertion. There may be exacerbations of an aggravating nature, often worsening over time.

In order to confirm the diagnosis of COPD in addition to the clinical signs of the disease, it is necessary to perform paraclinical investigations. For the definitive diagnosis of chronic obstructive pulmonary disease, spirometry is the gold standard. However, in addition, other methods to help differential diagnosis or complications are also necessary.
In which x-ray for these patients does not help confirm the diagnosis, but helps to assess the progression of the disease and differentiate it from other diseases.
The roles of x-ray in diagnosing chronic obstructive pulmonary disease:
When the patient shows signs such as: Chronic cough, shortness of breath, chest tightness, frequent sputum production, the first thing the patient will be X-ray film can help orient the diagnosis of chronic obstructive pulmonary disease by showing images of air retention, structural changes in the lungs, emphysema... Helps diagnose and rule out certain diseases clinical signs are similar to: left heart failure, lung cancer, pulmonary tuberculosis... Monitor the progression of the disease during the treatment process without invasive procedures. However, in order to optimize the benefits of x-rays for patients with suspected or chronic obstructive pulmonary disease, there are also standard film images and experienced doctors to avoid confusion due to imaging. Images or structures on film have images similar to some other lung diseases.

X-ray is quite simple, the patient does not need to prepare much, before taking the patient, the patient needs to change clothes at the request of the medical staff and remove the radiopaque objects from the survey area to avoid this phenomenon. fake image. Note that pregnant cases need to notify the doctor to take measures to prevent the risk of affecting the fetus.
Shooting position: The patient is taken in a standing position, can add a lying position if an epidemic is suspected.
Structural abnormalities on x-ray films of patients with COPD include:
Over-distention: In people with COPD, there is air retention in the lungs, leading to over-distention of the lungs. This condition causes damage to the lungs, losing the function of exhaling gases, making it difficult for the patient to breathe. Flat diaphragm: The result of overinflating the lungs causing the diaphragm to flatten. Air bubbles: Air bubbles on an X-ray are air sacs that can form and damage lung tissue. These air bubbles grow and take up space in the lungs without any function, thus reducing lung function. In the case of air bubbles, surgery is often indicated to remove these bubbles, because of the danger to the patient. Teardrop-shaped cardiac balloon: The heart balloon may change shape as the disease progresses due to compression of the distended lung. A teardrop-shaped heart shadow (narrow or elongated heart shadow) is typical in COPD. From the abnormal images on the x-ray film, it helps the doctor to orient the diagnosis of the disease and assign the paraclinical parameters to help diagnose the disease.
Although chest x-ray cannot help definitively diagnose COPD, it is also a simple, non-invasive tool to help differentiate and direct the disease. Patients with a history of smoking a lot, over 35 years old, showing signs of cough, sputum production, shortness of breath should be screened early.
In case the patient has suspected symptoms of the disease or an exacerbation of chronic obstructive pulmonary disease, they should immediately go to the doctor for diagnosis, assessment of progression - complications of the disease and timely treatment.
Periodic health check-ups help to detect diseases early, so that there are treatment plans for optimal results. Currently, Vinmec International General Hospital has general health checkup packages suitable for each age, gender and individual needs of customers with a reasonable price policy.
The patient's examination results will be returned to the home. After receiving the results of the general health examination, if you detect diseases that require intensive examination and treatment, you can use services from other specialties at the Hospital with quality treatment and services. outstanding customer service.