Asthma CT

Jump to navigation Jump to search

Asthma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Asthma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Pulmonary Function Test
Bronchial Challenge Test
Exhaled nitric oxide

Treatment

Emergency Management

Medical Therapy

Alternative and Complementary Medicine

Bronchial Thermoplasty

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Asthma CT On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Asthma CT

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Asthma CT

CDC on Asthma CT

Asthma CT in the news

Blogs on Asthma CT

Directions to Hospitals Treating Asthma

Risk calculators and risk factors for Asthma CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

In asthmatics, high-resolution CT may reveal several structural changes related to small-airway disease including cylindrical bronchiectasis, bronchial wall thickening, and air trapping.[1] CT markers valid for small-airway disease can be derived from quantitative lung density measurements and these markers correlate with clinical severity, lung function test results and are also sensitive to demonstrate therapeutic effects.[2] An FEV1/FVC ratio of 75% or more has been shown to be an important predictor of bronchial wall thickening and bronchiectasis; but has a low discriminatory utility for patients without structural airway changes (sensitivity, 67%; specificity, 65%). Thereby, suggesting the importance of radiological assessment of bronchial wall changes in patients with severe asthma.[3]

CT

  • Bronchial wall thickening,[4][5][6]
  • Patients with mild asthma have one or more dilated bronchi,[5][6]
  • Cylindrical bronchiectasis with the bronchoarterial- diameter ratio is less than 1.5,[7]
  • Bronchiolar mucus statis and constrictive bronchiolitis,
  • Centrilobular opacities subsequent to bronchiolar mucus stasis or peri- bronchiolar inflammation,
  • Areas of decreased attenuation and vascularity, as demonstrated at end-inspiration,
  • Air trapping, as demonstrated after maximal expiration.

References

  1. Robards VL, Lubin EN, Medlock TR (1975) Renal transplantation and placement of ileal stoma. Urology 5 (6):787-9. PMID: 1094668
  2. Laurent F, Tunon de Lara M (2011) Assessment of imaging techniques for evaluating small-airway disease in asthma. Rev Mal Respir 28 (6):e7-10. DOI:10.1016/j.rmr.2011.05.001 PMID: 21742230
  3. Gupta S, Siddiqui S, Haldar P, Raj JV, Entwisle JJ, Wardlaw AJ et al. (2009) Qualitative analysis of high-resolution CT scans in severe asthma. Chest 136 (6):1521-8. DOI:10.1378/chest.09-0174 PMID: 19542254
  4. Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology 188 (3):829-33. PMID: 8351357
  5. 5.0 5.1 Grenier P, Mourey-Gerosa I, Benali K, Brauner MW, Leung AN, Lenoir S et al. (1996) Abnormalities of the airways and lung parenchyma in asthmatics: CT observations in 50 patients and inter- and intraobserver variability. Eur Radiol 6 (2):199-206. PMID: 8797980
  6. 6.0 6.1 Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings. Radiology 203 (2):361-7. PMID: 9114089
  7. Mitchell TA, Hamilos DL, Lynch DA, Newell JD (2000) Distribution and severity of bronchiectasis in allergic bronchopulmonary aspergillosis (ABPA). J Asthma 37 (1):65-72. PMID: 10724299

Template:WH Template:WS