Jedei I. Radiation diagnosis of chronic obstructive pulmonary disease in the practice of medical and social examination - Qualifying work as a manuscript.

The aim of the study was to increase the effectiveness of radiation diagnosis of chronic obstructive pulmonary disease by objectifying the assessment of the severity of its course during medical - social examination using digital densitometry at MSCT. For this, a retrospective and prospective analysis of case histories of 126 patients who were hospitalized during 2016-2018 was performed: 92 patients with COPD, including COPD in combination with asthma - 20 patients (main group) and 34 patients with asthma (comparison group). The average age of the patients was 58,9±12,8 years (range 26 to 87 years). In the main group, prevailed (79,2%) men, in the comparison group - women (61,8%) (χ2=17,515; p<0,001). Most COPD patients corresponded to stage B (31,5%) and C (39,1%) and 2-3 stages. by the severity of obstruction according to GOLD 2016 criteria. Among patients with asthma patients with 3–4 st of disease were dominant. Disability due to the COPD had a 26 (28,3%) patients with predominance group III, while 18 (69,2%) of them were of working age (up to 60 years). In the comparison group, 12 (35,3%) patients had disability.The data obtained suggest that inspiratory and individual expiratory densitometric indices, especially those characterizing the inspiratory-expiratory ratio (PD15exp /PD15 and LDVIexp /LDVI), have significant strong correlations with the severity of the disease. Additionally, the relationship of the analyzed parameters with the disability group was studied in 55 patients of working age, among whom were 13 group III disabled people and 9 group II disabled people (there were no patients with group I). Preliminary analysis did not reveal significant differences according to the severity of bronchial obstruction (χ2=4,351; p=0,629), but with a significant increase in patients with COPD with stages C and D in the presence of III or II disability group. In the correlation analysis, only the FEV1 correlation was reliable (rSp=0,295; р=0,029). Among densitometric indicators, the highest correlation with the disability group was ES (rSp=0,889; р=0,011), LDVI exp (rSp=0,689; р=0,040) and PD15exp (rSp=-0,634; р=0,067), which indicates a decrease in lung density (PD15) and an increase in the prevalence of emphysema (LDVI) with disability. Summarizing the results of the study, we can state the feasibility of MSCT in patients with COPD: visual assessment for nosological diagnosis and differential diagnosis in combination with clinical and laboratory studies, densitometry - to assess the severity of structural and functional lesions of the bronchopulmonary system and disability in patients with pulmonary pathology.