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Multidetector row computed tomography to assess changes in airways linked to asthma control
Pierre-Y Brillet1, Valérie Attali, Gaëlle Nachbaur
1UPRES EA 2363, Service de radiologie, Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Paris 13, Bobigny, France. pierre-yves.brillet @ avc.aphp.fr
Respiration; International Review of Thoracic Diseases
|November 6, 2010
Summary
Multidetector row computed tomography (MDCT) showed airway caliber changes, not bronchial wall thickness, in asthma patients achieving control after treatment. These findings suggest MDCT may reflect elastic property modifications rather than structural changes.
Area of Science:
- Pulmonary Medicine
- Radiology
- Asthma Research
Background:
- Multidetector row computed tomography (MDCT) in asthma identifies abnormalities linked to disease severity, such as increased bronchial wall thickness.
- The relationship between these airway abnormalities and asthma control remains under-investigated.
Purpose of the Study:
- To investigate the link between airway changes detected by MDCT and asthma control.
- To evaluate the impact of a 12-week salmeterol/fluticasone propionate treatment on airway parameters in patients with poorly controlled asthma.
Main Methods:
- A 12-week study involving 12 patients with poor asthma control treated with salmeterol/fluticasone propionate.
- MDCT scans (low-dose protocol) and clinical/functional assessments were performed pre- and post-treatment.
- Bronchial lumen (LA) and wall areas (WA) were quantified using BronCare software; lung density was also measured.
Main Results:
- Asthma control was achieved post-treatment, with significant improvements in FEV(1) and expiratory reserve volume.
- No significant changes were observed in overall bronchial lumen (LA) or wall areas (WA).
- However, half of the patients showed a >10% decrease in LA, with considerable heterogeneity, alongside decreased lung density in specific areas.
Conclusions:
- MDCT appears insensitive to detecting decreases in bronchial wall thickness in asthma patients undergoing treatment.
- Observed changes in bronchial caliber, rather than wall thickness, may be related to treatment-induced modifications in the elastic properties of the respiratory system.
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