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CT imaging in children with non-severe asthma and cough-variant asthma: functional spasm or structural remodeling?
Li Wang1, Chunying Liu2, Yinghong Fan1
1Department of Pediatric Respiratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Insights
Computed tomography (CT) reveals airway remodeling in children with early-stage non-severe asthma and cough-variant asthma (CVA). Bronchial wall thickness and area were significantly increased in these pediatric patients compared to controls.
Area of Science:
- Pediatric Pulmonology
- Respiratory Imaging
- Airway Diseases
Background:
- Asthma is a common chronic respiratory disease in children.
- Airway remodeling, characterized by structural changes in the airways, is increasingly recognized in pediatric asthma.
- Cough-variant asthma (CVA) presents primarily with chronic cough and may involve similar airway pathology to classic asthma.
Purpose of the Study:
- To investigate the utility of CT-measured bronchial wall thickness and area in detecting airway remodeling.
- To compare airway remodeling parameters in children with non-severe asthma and CVA against healthy controls.
Main Methods:
- A retrospective review of 140 children (non-severe asthma, CVA, and control groups) was performed.
- CT scans were analyzed to measure bronchial wall area (WA), wall thickness (WT), WA%, and WT% in specific segmental bronchi.
- Clinical characteristics, pulmonary function, and CT parameters were compared across groups.
Main Results:
- Bronchial wall area and thickness were significantly higher in both non-severe asthma and CVA groups compared to controls (p < 0.05).
- No significant differences in age, gender, white blood cell count, or eosinophil count were found between patient and control groups.
- CT parameters did not significantly differ between subgroups with or without small airway dysfunction (SAD) or obstructive ventilatory disorder (OVD).
Conclusions:
- CT findings suggest early-stage airway remodeling in pediatric non-severe asthma and CVA.
- Despite clinical differences, CVA patients may exhibit similar airway remodeling patterns to classic asthma.
- CT-based measurements of bronchial wall parameters are valuable for identifying airway remodeling in pediatric asthma subtypes.
Objective:
To investigate the role of CT-measured bronchial wall thickness and area in detecting airway remodeling in children with non-severe asthma and cough-variant asthma.
Methods:
A retrospective review was conducted on 140 children who were assigned to the non-severe asthma (AS, n = 51), cough-variant asthma (CVA, n = 50) and control (CTL, n = 39) groups at Chengdu Women's and Children's Central Hospital from January 2023 to June 2025. Clinical characteristics, pulmonary function, and CT-measured parameters were compared across the groups.
Results:
The wall area (WA), wall thickness (WT), wall area percentage (WA%), and wall thickness percentage (WT%) were measured in the third and fourth segments of right upper lobe apical segmental bronchus (RB1), right lower lobe posterior basal segmental bronchus (RB10) and left lower lobe posterior basal segmental bronchus (LB10). These parameters were significantly higher in both the AS and CVA groups compared to the CTL group (p < 0.05). No statistically significant differences in age, gender, white blood cell count (WBC) or eosinophil count (EOS) were observed between the patient group (AS and CVA) and CTL group. Based on pulmonary function results, children with asthma or CVA were divided into groups with or without small airway dysfunction (SAD) and with or without obstructive ventilatory disorder (OVD). The comparative analysis showed that the majority of CT-measured parameters did not exhibit any statistically significant differences when comparing the SAD group to the non-SAD group, or the OVD group to the non-OVD group.
Conclusion:
In conclusion, the CT results suggest that there may be airway remodeling in non-severe asthma and CVA patients in the early stages of the disease. Although patients with CVA differ from those with classic asthma in their clinical presentation and pulmonary function, they may share the same pattern of airway remodeling.
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