Keywords
Abstract
Patients with COPD are at greater risk of pneumonia and many other respiratory infections than healthy population, and pneumonias are characterized by severe course and development of respiratory failure. Differential diagnosis of pneumonic infiltrates is complicated, because of etiology. Purpose: to evaluate the possibilities of radiologic methods in the differential diagnosis of pneumonic infiltrates in patients with COPD. Тhe results of a comprehensive clinical and radiologic examination of patients with predominantly emphysematous type of COPD were analyzed during exacerbation: 55 patients, group B, GOLD II and 78 patients with COPD, group D, GOLD III and IV (GOLD, 2017). CT-examination in all patients we founded out regions of consolidation of different sizes and x-ray signs of increased pneumatization of the pulmonary tissue, because of emphysema. In addition, in 92 patients (69.2%) we detected discoid atelectasis, free fluid in the pleural cavity was revealed in 23 patients (17.3%), extension of the pulmonary artery in 16 patients (12%) and high standing dome of the diaphragm was founded out in 7 patients (5.3 percent). Conclusions: the differential radialogic diagnosis of infiltrative changes in pneumonia should include assessment of the density of inflammatory infiltration, its location, features of blood circulation ( hyper- and hypoperfusion). The angiographic study helped to identify thrombotic masses in the lumen of pulmonary arteries of large and medium caliber, revealed indirect signs of pulmonary embolism of small branches, helped to identify neoplastic processes, as well as inflammatory changes in the pulmonary tissue, and to determine factors influencing the prognosis of the disease. In case of ambiguous interpretation of disc-shaped atelectasis, avascular areas and areas of pneumonic infiltration of pulmonary tissue in MSCT, it is necessary to perform SPECT or combined SPECT-CT studies.