On Bronchiolar Lesions of Chronic Bronchitic Syndrome : Relationship between Small Nodular Shadows and Respiratory Functions

Twenty-nine cases of chronic obstructive lung diseases other than bronchial asthma and cystic bronchiectasis were evaluated for the relationship between abnormal findings on chest radiographs with particular concern for small nodular shadows and respiratory functions. These cases were divided into two groups ; Group A with 17 cases not showing emphysematous findings on the chest roentgenogram, and Group B with 12 cases exhibiting such findings. The degree of intensity and extension of small nodular shadows observed in Group A indicated a highly significant correlation with %VC and RV/TLC%. In Group A, as the severity of small nodular shadows increased, the %VC tended to decrease accompanied by an increased RV/TLC%. The severity of small nodular shadows correlated significantly with the results of the following tests, FEV1.0%, % 50, % 25 and CC/TLC%. No correlation, however, was observed in Group B between the severity of small nodular shadows and the results of respiratory functions. Two possibilities were suggested by the observations made on Group B. First, emphysematous findings on the chest roentgenogram may have exhibited a greater influence on respiratory function than did small nodular shadows. The second possibility is that the emphysematous findings made it difficult to recognize the small nodular shadows. The results of respiratory functions in Group B were compatible with chronic pulmonary emphysema. In conclusion, small nodular shadows on chest roentgenograms of patients with chronic bronchitic syndrome seem to indicate abnormalities of the small airways