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Peripheral airways obstruction on high-resolution computed tomography in chronic severe asthma
1Department of Radiology, Royal Brompton National Heart and Lung Hospital, London, U.K.
Respiratory Medicine
|August 6, 1998
Summary
Chronic severe asthma involves airway structural changes, particularly peripheral airway obstruction. High-resolution CT scans reveal air trapping, correlating with reduced lung function and increased asthma severity.
Area of Science:
- Pulmonary Medicine
- Radiology
- Respiratory Physiology
Background:
- Chronic severe asthma can lead to structural alterations in both proximal and distal airways.
- Understanding these changes is crucial for managing severe asthma cases.
Purpose of the Study:
- To assess structural airway changes in chronic severe asthma using high-resolution computed tomography (CT).
- To investigate the relationship between airway morphology, air trapping, and lung function (FEV1).
Main Methods:
- High-resolution CT scans were performed on 24 chronic severe asthma patients during full inspiration and expiration.
- Scans were analyzed by two radiologists to identify airway dilatation, thickening, and air trapping.
- Quantitative analysis included the expiratory-to-inspiratory cross-sectional area ratio (Exp/Ins).
Main Results:
- Air trapping was observed in 20 out of 24 patients, indicated by increased lucency on expiratory scans.
- The mean Exp/Ins ratio was significantly higher in asthmatic patients (75.9%) compared to historical controls (44.6%).
- Reduced FEV1 (% predicted) correlated significantly with air trapping (Exp/Ins ratio and CT features).
Conclusions:
- Peripheral airway obstruction is a significant finding in chronic severe asthma.
- Air trapping, visualized by CT, is linked to reduced lung function and may contribute to asthma severity.