Source: Annual Congress 2010 - State of the art imaging
Disease area: Airway diseases

Abstract

Asthma is characterized by structural changes of small and large airways, whose assessment has required invasive procedures. We used high resolution computed tomography (HRCT) to evaluate 1) the extent and 2) the severity of structural changes of the airways of asthmatics as compared to COPD subjects. Seventeen moderate-severe asthmatics (M/F: 10/7) and and 8 COPD subjects (M/F: 7/1) with similar degree of bronchial obstruction (FEV1/FVC: for asthma, 0.60±0.10; for COPD, 0.64±0.12, p=0.40; FEV1% pred: for asthma, 65±20%; for COPD, 58±11%, p=0.36; mean±SD) underwent HRCT scanning. Airway wall thickness (AWT) was measured as the mean of 4 lines, randomly drawn through the airway wall (Image J software), and expressed as the percentage of the diameter of the airway (T). In addition, the area of the airway wall was measured as the difference of the total area and the area of the lumen, and expressed as percentage of the total area (A). A total of 371 airways were selected and retained for analysis. Airways were divided according to their internal diameter (small airways: <2 mm; large airways: >2 mm). In asthmatics, AWT was significantly different between the two groups (small airways vs. large airways: T: 29±2.9% vs. 23±2.8%; p <0.0001; A: 77±6.0% vs. 75±6.5%, p=0.006). When compared with the COPD findings, no differences were detected between the two diseases (asthma vs. COPD: for small airways, T: 29±2.9% vs. 29±2.0%, p=0.80; A: 83±5.5% vs. 85±2.5%, p=0.50; for large airways: T: 23±2.8% vs. 22±1.7%, p=0.29; A: 75±6.5% vs. 74±5.1%, p=0.62). These findings suggest that structural changes in asthma involve the entire bronchial tree, and are quantitatively comparable to those of COPD of similar degree of bronchial obstruction.

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G. B. Figlioli, M. Bellia, N. Scichilone, F. Cannizzaro, M. Midiri, R. Lagalla, V. Bellia (Palermo, Italy). Airway wall thickness in asthma and COPD by HRCT. Eur Respir J 2010; 36: Suppl. 54, 5289

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