Patients with chronic bronchitis may have completely normal chest X-rays or lung CT scans in the early stages, meaning that if a patient exhibits symptoms of chronic bronchitis, such as coughing and expectorating for more than three months continuously or over two consecutive years, they can still be diagnosed with chronic bronchitis even if their chest X-ray appears normal. Additionally, as chronic bronchitis progresses over time, some patients may develop thickening of the bronchial walls or interstitial inflammation in the small bronchioles and alveoli, etc. These conditions can manifest on chest X-rays as coarse, disordered lung textures in a net-like or strip-like pattern, or as patchy shadows, which are generally more evident in the lower fields of both lungs. Observing these changes on a chest X-ray can assist in diagnosing chronic bronchitis. Furthermore, as the disease progresses, some patients with chronic bronchitis may develop into chronic obstructive pulmonary disease (COPD) or pulmonary heart disease, and corresponding changes might be observable on chest X-rays. Additionally, patients with chronic bronchitis often experience acute exacerbations or concurrent infections, which may lead to patchy exudates visible on the chest wall.