A morphologic study of the airway structure abnormalities in patients with asthma by high-resolution computed tomography

Abstract

Background: Airway structure changes, termed as airway remodeling, are common in asthma patients due to chronic inflammation, which can be assessed by high-resolution computed tomography (HRCT).Considering the controversial conclusions in the correlation of morphologic abnormalities with clinical feature and outcome, we aimed to further specify and evaluate the structural abnormalities of Chinese asthmatics by HRCT.Methods: From August 2012 to February 2015, outpatients with asthma were recruited consecutively in the Asthma Center of West China Hospital, Sichuan University. Standard HRCT and pulmonary function test (PFT) were performed to collect information of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, atelectasis, and spirometric parameters. We reported the incidence of each structural abnormality in HRCT and compared it among different asthmatic severities.Results: A total of 123 asthmatics were enrolled, among which 84 (68.3%) were female and 39 (31.7%) were male. At least one structural abnormality was detected by HRCT in 85.4% asthmatics, and the incidence of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, and atelectasis was 57.7%, 51.2%, 22%, 24.4%, 5.7% and 1.6%, respectively. The incidences of bronchial wall thickening, bronchial dilation and emphysema were significantly increased by asthma severity (P<0.05), while incidences of mucus impaction (26/27, 96.30%), mosaic perfusion (6/7, 85.71%) and atelectasis (2/2, 100%) were mainly found in severe asthma. We found a longer asthma history (28.13±18.55 years, P<0.001, P=0.035, respectively).Conclusions: The incidences of structural abnormalities detected by HRCT are fairly high in Chinese asthma populations, especially the bronchial wall thickening and bronchial dilation, which are significantly increased in severe asthma, and are potential risk factors of pulmonary function decline in asthmatics.

Differences in the Clinical Characteristics of Early- and Late-Onset Asthma in Elderly Patients

“…Prevalence of coexisting COPD in asthma in our study was lower than that in other studies [32,33]. e coexistence of bronchiectasis and asthma has also been observed in many patients, especially in Chinese asthma populations [34,35]. e exact causal relationship between bronchiectasis and asthma has not been fully understood.…”

Bronchiectasis and increased mortality in patients with corticosteroid-dependent severe asthma: a nationwide population study

“…Although the prevalence of bronchiectasis is generally low in all patients with asthma, the prevalence increases by up to 25–51% in those with severe asthma. 13 , 28 , 29 Several studies reported a significant association between asthma exacerbation risk and bronchiectasis. 13 , 30 However, increased mortality in severe asthma due to bronchiectasis has not previously been published and is the novel finding of this study.…”

Bronchiectasis in Severe Asthma: Does It Make a Difference?

“…Actual numbers about prevalence of BE in asthma vary among studies from <5% in overall asthma populations to 25–40% in uncontrolled or more severe asthma [3, 8-10]. This wide variability may be related to differences in study design or radiological methods used but probably is largely due to the heterogeneity of the included asthma cohorts.…”