High-Resolution Computed Tomography Findings Are Correlated with Disease Severity in Asthma

Harmancı, Emel; Kebapçı, Mahmut; Metintaş, Muzaffer; Özkan, Ragıp

doi:10.1159/000064018

Cited by 70 publications

(67 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, they did not find the relationship between HRCT abnormalities and disease severities (14). In the study by Harmanci and colleagues (15), the incidence of bronchial wall thickening, bronchial dilatation, mucus impaction, and emphysema was reported as 67.9%, 9.3%, 1.8%, and 7.9% respectively, but they found that bronchial wall thickening, bronchial dilation, and mucus impaction were all correlated positively with asthma severity while negatively with forced expiratory volume in one second (FEV 1 ), which were further demonstrated by Park and Nakano (9,10). A study in China analyzed retrospectively the abnormalities of 28 asthma patients by HRCT, and the results showed a positive rate of 71.4%, of which bronchial wall thickening was detected in 15 cases (53.6%), while bronchial dilation was in 6 cases (21.4%), and mosaic pattern was in 3 cases (11.8%) (16).…”

Section: Introductionmentioning

confidence: 90%

“…Furthermore, for a long time asthma is speculated to be more of a functional disease than a structural disease, which is distinct from chronic obstructive pulmonary disease (COPD), and airway structure abnormalities are indeed rarely found by chest film in asthmatics. However, in recent years, it has been recognized that airway remodeling is one of the important pathological abnormalities in patients with asthma and could lead to airway morphological changes, and an increasing number of studies have focused on the use of highresolution computed tomography (HRCT) to evaluate the airway structure changes (8)(9)(10)(11)(12)(13)(14)(15). It was reported that HRCT could be used to quantify static and dynamic changes in multiple independent airways as small as 1 mm (8), thus making it possible to study the subtle structure changes in the airways of asthma patients.…”

Section: Introductionmentioning

confidence: 99%

“…It was reported that the overall incidence of abnormalities in HRCT was as high as 72% in asthma patients (14,15). However, the incidence of individual abnormality varied in different studies, and the exact relationship between airway structure changes and asthma severities did not reach a consensus.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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.

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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.

View full text Add to dashboard Cite

show abstract

“…HARMANCI et al [43] demonstrated that bronchial wall thickening was more prominent with increased severity, decreased forced expiratory volume in one second (FEV1) values and the duration of asthma. The submucosa of asthmatic subjects contained more blood vessels; this also correlated with the severity of the disease [44].…”

Section: Is Remodelling Positively Correlated To Disease Severity?mentioning

confidence: 99%

The contribution of transforming growth factor-β and epidermal growth factor signalling to airway remodelling in chronic asthma

Boxall

Holgate²,

Davies³

2006

Eur Respir J

226

187

View full text Add to dashboard Cite

Asthma is increasing in prevalence in the developing world, affecting ,10% of the world's population. It is characterised by chronic lung inflammation and airway remodelling associated with wheezing, shortness of breath, acute bronchial hyperresponsiveness to a variety of innocuous stimuli and a more rapid decline in lung function over time.Airway remodelling, involving proliferation and differentiation of mesenchymal cells, particularly myofibroblasts and smooth muscle cells, is generally refractory to corticosteroids and makes a major contribution to disease chronicity. Transforming growth factor-b is a potent profibrogenic factor whose expression is increased in the asthmatic airways and is a prime candidate for the initiation and persistence of airway remodelling in asthma.This review highlights the role of transforming growth factor-b in the asthmatic lung, incorporating biosynthesis, signalling pathways and functional outcome. In vivo, however, it is the balance between transforming growth factor-b and other growth factors, such as epidermal growth factor, which will determine the extent of fibrosis in the airways.A fuller comprehension of the actions of transforming growth factor-b, and its interaction with other signalling pathways, such as the epidermal growth factor receptor signalling cascade, may enable development of therapies that control airway remodelling where there is an unmet clinical need.

show abstract

“…High-resolution CT (HRCT) has recently gained increasing attention as an evaluation method of bronchial remodelling in asthma patients [1]. The efficiency of HRCT has been proven by numerous studies [2][3][4][5]. Optimisation of the radiation beam parameters enables identification of structures down to 100-200 mm in size and allows for evaluation of even the smallest bronchi (1.5-2 mm in diameter) [6].…”

Section: Discussionmentioning

confidence: 99%

Adjusted subpixel method enables optimisation of bronchial measurements in high-resolution CT

Mincewicz¹,

Aloszko²,

Rumiński³

et al. 2012

The British Journal of Radiology

View full text Add to dashboard Cite

Objectives: The purpose of this paper is to present a new technique of high-resolution computed tomography (HRCT) bronchial measurement, which was worked out in our centre and is based on a mathematically adjusted subpixel method (ASM). Methods: This study used a bronchial tree model comprising two polyvinyl chloride/ rubber pipes with various densities placed in a larger plastic object. External and internal diameters of both pipes corresponded to the sizes of structures that are usually evaluated in HRCT scans (i.e. the bronchus with accompanying blood vessel). The model was subjected to repeated HRCT measurements of the external and internal diameters of model pipes using a subpixel technique and ASM. Results: Significant differences were observed between mean values of external and internal diameters of model pipes determined by means of subpixel method or ASM, with the latter being the ones that resembled real diameters of the model pipes more closely. Mean external diameters of the larger and smaller model pipes determined by ASM differed from the real diameters by 0.23% and 0.57%, respectively. The internal diameter of the larger pipe was on average 25.96% larger, whereas the internal diameter of the smaller pipe was 48.05% smaller than the real diameter. Conclusion:The technique of non-linear prediction of HRCT bronchial measurements described in this paper raises attractive prospects in its clinical application owing to potential improvements in the objectivity and reproducibility of bronchial wall measurements. High-resolution CT (HRCT) has recently gained increasing attention as an evaluation method of bronchial remodelling in asthma patients [1]. The efficiency of HRCT has been proven by numerous studies [2][3][4][5]. Optimisation of the radiation beam parameters enables identification of structures down to 100-200 mm in size and allows for evaluation of even the smallest bronchi (1.5-2 mm in diameter) [6]. Because of the aforementioned characteristics, HRCT is useful in the diagnosis and evaluation of many pathologies, including bronchial wall thickening, bronchiectasis, mucus plugging and emphysema or atelectasis [7][8][9][10][11].Owing to its many advantages, HRCT is likely to become the standard tool for disease evaluation in patients with difficult/refractory asthma [12][13][14][15]. However, a number of constraints are associated with the application of this otherwise valuable method. The first constraint is the lack of clearly defined clinical criteria for asthma evaluation in HRCT scans [16]. Among the proposed criteria, disease-related changes in bronchial wall thickness and bronchial lumen diameter seem to be the most reasonable. However, repeating and comparing measurements obtained at different time points is often frustrated by the low reproducibility of HRCT-based measurements. This problem results mostly from the wide use of eye-driven, non-standardised techniques of measurements.A number of attempts towards optimising HRCT measurements have been undertaken, mostly based on model syste...

show abstract

High-Resolution Computed Tomography Findings Are Correlated with Disease Severity in Asthma

Cited by 70 publications

References 21 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

The contribution of transforming growth factor-β and epidermal growth factor signalling to airway remodelling in chronic asthma

Adjusted subpixel method enables optimisation of bronchial measurements in high-resolution CT

Contact Info

Product

Resources

About