[Lung imaging in severe asthma].

Area of Science:

• Pulmonary Medicine
• Radiology
• Medical Imaging

Background:

• Asthma diagnosis typically does not rely on imaging.
• Chest CT has become vital in managing difficult-to-treat and severe asthma over the past decade.
• Common CT findings in asthma include bronchial wall thickening and lumen changes, reflecting obstruction and remodeling.

Purpose of the Study:

• To highlight the role of chest CT in severe asthma management.
• To discuss CT findings that can mimic asthma.
• To explore the potential of quantitative imaging in asthma phenotyping and treatment response evaluation.

Main Methods:

• Review of current literature and clinical practice regarding chest CT in asthma.
• Analysis of CT findings associated with asthma and differential diagnoses.
• Discussion of advanced imaging techniques like CT and MRI for quantitative analysis.

Main Results:

• Chest CT is indicated in severe asthma for identifying alternative or additional diagnoses.
• Bronchial wall thickening on CT correlates with obstruction and inflammation.
• Specific CT findings like hyperdense mucous plugging suggest allergic bronchopulmonary aspergillosis.

Conclusions:

• Quantitative imaging (CT/MRI) can identify patient subgroups based on morphology and function.
• These imaging tools may serve as novel biomarkers for treatment response.
• Chest CT aids in phenotyping severe asthma patients.