Airway changes in Asthma patients assessed by High-Resolution Computed Tomography: A cross-sectional study

Uncontrolled and partly controlled asthma can result in permanent changes to the airways. Assessing these changes can help to plan asthma management. High-resolution computed tomography (HRCT) provides a potentially non-invasive technique for measuring airway changes in patients with asthma. This study aims to assess the HRCT findings in patients diagnosed with asthma and to compare the findings of HRCT among patients with various levels of asthma control.

This was an observational cross-sectional study conducted in a tertiary care hospital on 50 asthma patients who were subjected to HRCT thorax. Airway dimensions and structural changes were measured and analyzed among well-controlled, partly controlled and poorly controlled asthma patients.

The average age of patients in our study was 40.9 ± 16.61 years, with the majority (36%) in the 21-35-year age group and a male-to-female ratio of 0.8:1. Over half of the patients (54%) had asthma for less than 10 years. Asthma control was well controlled in 48%, partly controlled in 38%, and poorly controlled in 14% of patients. On HRCT, air trapping (68%) was the most common finding, followed by bronchiectasis (18%) and atelectasis (16%). Most patients with poorly controlled asthma showed HRCT abnormalities. Bronchial wall thickness, total bronchial area, airway wall area, and percentage of airway wall area were significantly higher (p<0.0001) in poorly controlled asthma, whereas bronchial luminal area was significantly lower (p<0.0001).

Our study demonstrates that airway wall thickness and related HRCT parameters are significantly increased in patients with poorly controlled asthma compared to those with partly or well-controlled disease. These findings underscore the potential of HRCT as a non-invasive tool to assess structural airway changes associated with asthma control status. However, given the cross-sectional nature and limited sample size, further research is needed to evaluate the prognostic value of HRCT findings, their relationship with clinical outcomes, and their potential role in guiding individualized treatment strategies.