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Related Experiment Video

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Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
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Relationships Between High-Resolution Computed Tomographic Features and Lung Function Trajectory in Patients With

Joo-Hee Kim1, Kyung Eun Shin2, Hun Soo Chang3

  • 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.

Allergy, Asthma & Immunology Research
|April 6, 2023
PubMed
Summary

A simple scoring method using high-resolution computed tomography (HRCT) can help assess airway remodeling in asthma. Emphysema and bronchial wall thickening (BWT) are key indicators linked to persistent airflow limitation in asthmatics.

Keywords:
Asthmaairway remodelingcomputed tomographyemphysemaforced expiratory volume

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Respiratory Research

Background:

  • Asthma can lead to persistent airflow limitation, termed remodeled asthma, even with optimal treatment.
  • Current quantitative scoring for airway remodeling on HRCT is time-consuming.
  • Simpler clinical assessment methods for airway remodeling are needed.

Purpose of the Study:

  • To evaluate the clinical usefulness of a simple, semi-quantitative HRCT scoring method.
  • To compare asthmatics with persistent airflow limitation versus those with normalized lung function.
  • To assess the relationship between HRCT parameters and post-bronchodilator FEV1 (BD-FEV1).

Main Methods:

  • 59 asthmatics were categorized into 5 trajectories based on BD-FEV1 changes over 1 year.
  • Eight HRCT parameters were assessed (emphysema, bronchiectasis, anthracofibrosis, BWT, fibrotic bands, mosaic attenuation, air-trapping, nodules).
  • Parameters were scored as present (1) or absent (0) in 6 lung zones after 9-12 months of treatment.

Main Results:

  • The group with persistent BD-FEV1 decline (Tr5) was older and showed higher emphysema and BWT scores.
  • Asthmatics with normalized BD-FEV1 (Tr4) had longer asthma duration, more exacerbations, and higher steroid use.
  • Emphysema and BWT scores were inversely correlated with BD-FEV1 in multivariate analysis.

Conclusions:

  • Emphysema and bronchial wall thickening (BWT) are significantly associated with airway remodeling in asthma.
  • A simple, semi-quantitative HRCT scoring system offers an accessible method for estimating airflow limitation.
  • This method aids in assessing airway remodeling in clinical practice.