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Low-density areas on high-resolution computed tomograms in chronic pediatric asthma
Massimo Pifferi1, Davide Caramella, Vincenzo Ragazzo
1Department of Pediatrics, University of Pisa, Italy.
The Journal of Pediatrics
|July 2, 2002
Summary
Persistent increased residual volume (RV) in children with asthma after treatment may indicate emphysema-like changes on lung imaging. This finding suggests RV can help identify these structural changes in pediatric asthma patients.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Thoracic Imaging
Background:
- Asthma in children can lead to persistent airway inflammation and airflow limitation.
- Emphysema-like changes, characterized by low-density areas on CT scans, are a concern in chronic respiratory diseases.
Purpose of the Study:
- To investigate the correlation between increased residual volume (RV) and low-density areas on high-resolution computed tomography (HRCT) in children with persistent asthma post-treatment.
- To determine if RV can serve as a marker for emphysema-like structural changes in pediatric asthma.
Main Methods:
- A prospective study involving 32 children diagnosed with asthma.
- Patients received a 3-month treatment regimen of salmeterol and fluticasone.
- Evaluated airflow parameters, serum eosinophil cationic protein (ECP), RV, and HRCT findings before and after treatment.
Main Results:
- All patients showed improvement in lung function and reduced airway inflammation markers (ECP).
- 10 out of 32 children (31.2%) exhibited low-density areas on HRCT, indicative of emphysema-like changes, despite normalized lung function tests.
- A strong correlation (r = 0.84, P <.0001) was observed between persistent RV >150% predicted and the presence of these low-density areas.
Conclusions:
- Asthmatic children can exhibit structural lung changes resembling emphysema.
- Persistent elevated RV after anti-inflammatory treatment is a potential indicator for identifying emphysema-like changes on HRCT in pediatric asthma.