This article reviews the radiologic manifestations and complications o
f chronic obstructive pulmonary disease, particularly those seen in as
sociation with emphysema. Current concepts on the pathogenesis of chro
nic obstructive pulmonary disease are discussed and related to finding
s on high-resolution CT scan and histologic examinations. Controversia
l issues concerning the detection and grading of emphysema using radio
logic and physiologic tests are also addressed.