Radiologic and physiologic correlation in apparently healthy smoker

Background: Pulmonary damage induced by smoking acts slowly and may or may not show symptoms which are related to pulmonary function or radiological effect. Objectives: To correlate findings on history, chest X-ray, pulmonary function test high resolution computed tomography (HRCT) scans and to determine whether these findings may be useful in diagnosis of lung damage. Methods: This study comprised 50 subjects (10 healthy volunteers, 40 smokers) who underwent history taking, CXR, pulmonary function tests (spirometry and lung volumes) and both inspiratory and expiratory HRCT. Results: Pulmonary function measurement in studied groups showed obstructive pattern with highly significant difference. Chest X-ray showed hyperinflation in 38% in group II, 79% in group III, 90% in group IV. Mosaic perfusion was present in 3 cases 19%, 7 cases 50%, 5 cases 50%, paraseptal emphysema was present in 7 cases 44%, 11 cases 78%, 7 cases 70%, centrilobular emphysema was present in 4 cases 25%, 6 cases 43%, 4 cases 40% and bullae was present in 7 cases 44%, 8 cases 57%, 5 cases 50% in groups II, III, VI, respectively. Wheezes and cough showed significant negative correlation with FEF25–75% and PEF, while dyspnea showed positive correlation with bullae. Cough showed significant correlation with radiological finding, mosaic perfusion and centrilobular emphysema. There was significant correlation between tests of small airway and radiological finding in chest X-ray and high resolution computed tomography. Conclusion: We conclude that there was a functional and pathological impairment in the lung as cigarette consumption increases and chest symptoms in smoker appears to be related to small airway affection