Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.

Park, Chan Sup; Müller, Néstor L.; Worthy, S. A.; Kim, Joung Sook; Awadh, N.; FitzGerald, Mark

doi:10.1148/radiology.203.2.9114089

Cited by 165 publications

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“…According to these criteria, the prevalence of bronchial dilatation in asthmatic patients has been reported to be 3% to 66.7% (40,42). Bronchial dilation can also occur in healthy subjects, but the prevalence has been reported to be much lower than that in asthmatic subjects (28,30,41,43). Cylindrical bronchial dilation was reported to be the most common morphologic pattern identified on CT scans of asthmatics, mainly involved in segmental and distal bronchi, especially in the lower lobes (14,15,43).…”

Section: Discussionmentioning

confidence: 99%

“…Bronchial dilation was considered if the internal diameter of any bronchi was greater than that of the adjacent pulmonary artery, the bronchial lumina (distal to bifurcation) had a lack of tapering and was greater than 2 cm, or if the peripheral airways (within 1 cm of the costal pleura) was visible ( Figure 2) (15,28,31,32). Bronchial dilation were divided into three types according to the morphology of bronchi: (I) cylindric bronchial dilation, defined as the lack of bronchial tapering or the presence of smooth bronchial dilatation, and bronchial lumen greater than that of the accompanying pulmonary artery ( Figure 2A,B); (II) varicose bronchial dilation, identified when irregular or beaded dilatation of the bronchus were recognized ( Figure 2B,C); and (III) cystic bronchial dilation, diagnosed by presence of evident strings or clusters of cysts (15,33,34).…”

Section: Assessment Of Bronchial Dilationmentioning

confidence: 99%

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

Wang¹,

Luo²,

Du³

et al. 2016

J. Thorac. Dis.

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Assessment Of Bronchial Dilationmentioning

confidence: 99%

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

Wang¹,

Luo²,

Du³

et al. 2016

J. Thorac. Dis.

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“…The frequency with which air-trapping is identified on HRCT increases with age as does the extent, which is also influenced by cigarette smoking [17,109]. A relatively high prevalence of mosaic pattern has been reported in a study of 14 healthy subjects and 39 asthmatic individuals; a mosaic pattern was seen with equal frequency in both groups (21% and 18%) [110]. In addition, trivial extents of airtrapping on expiratory CT occurred with similar frequency in both groups (54% and 49%), whereas severe air-trapping was seen much less frequently in healthy subjects than asthmatics (14% versus 50%).…”

Section: Accuracy Of High-resolution Computed Tomography Signs and Inmentioning

confidence: 95%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

146

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Diseases affecting the small airways are difficult to detect by traditional diagnostic tests. Widespread involvement is needed before symptoms and abnormalities on pulmonary function testing or chest radiography become apparent. Obstruction of the bronchioles may be detected indirectly by computed tomography (CT) because regional under-ventilation results in reduced perfusion which in turn is shown as a mosaic attenuation pattern of the lung parenchyma. When there is inflammation of the bronchioles with accompanying exudate, the airways may become directly visible on CT, for example in cases of diffuse panbronchiolitis.Quantification of the various morphological features of small airways disease is possible from CT images and this increased precision has aided investigations of structure/function relationships.An understanding of the pathology and microscopic distribution of disease in relation to the airways allows some prediction of the likely computed tomography appearances in this wide spectrum of conditions, and thus helps to refine the differential diagnosis.

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“…BEIGELMAN-AUBRY et al [70] demonstrated a lower baseline airway lumen area in asthmatics compared with controls pre-bronchodilator, but the difference was abolished after salbutamol. In addition, the airway lumen diameter to arterial diameter ratio has been reported to be lower in asthmatic patients with a forced expiratory volume in one second (FEV1) ,60% (mean¡SD 0.48¡0.11) compared with control subjects (0.65¡0.16) and asthmatics who had normal or slightly decreased FEV1 values (0.60¡0.16 and 0.60¡0.18, respectively) [71]. Conversely, NIIMI et al [72] found no decrease in lumen area in the right apical upper lobe bronchus in asthmatics, irrespective of disease severity, compared with a normal group.…”

Section: Airway Imaging In Asthma Airway Dimensionsmentioning

confidence: 99%

Computed tomographic imaging of the airways: relationship to structure and function

Jong

Müller²,

Paré³

et al. 2005

Eur Respir J

157

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Alterations in the structure of the airways, collectively termed airway remodelling, contribute to airflow obstruction in a variety of chronic lung diseases. While histology has provided valuable insights into the structure of airway wall remodelling, this technique is invasive and does not allow the longitudinal analysis of airway wall dimensions. Technical advances in computed tomography allow the assessment of airway wall dimensions, and are ideally suited for the noninvasive investigation of the pathogenesis of airway wall remodelling and the evaluation of new therapeutic interventions. The aim of this article is to review the use of computed tomography in the investigation of airway structure and function in health and disease.

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Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.

Abstract: Thin-section CT is of limited value in distinguishing asthmatic patients with normal airflow or mild airflow obstruction from healthy subjects.

Cited by 165 publications

References 0 publications

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

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

Small airways diseases: detection and insights with computed tomography

Computed tomographic imaging of the airways: relationship to structure and function

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