Asthma CT: Difference between revisions
No edit summary |
m (Bot: Removing from Primary care) |
||
(3 intermediate revisions by 2 users not shown) | |||
Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Asthma}} | {{Asthma}} | ||
{{CMG}}; {{ | {{CMG}}; {{AE}} {{LG}} | ||
==Overview== | ==Overview== | ||
In asthmatics, high-resolution CT may reveal several structural changes related to | In asthmatics, high-resolution CT may reveal several structural changes related to small-airway disease including [[Bronchiectasis|cylindrical bronchiectasis]], bronchial wall thickening, and [[air trapping]].<ref name="pmid1094668">Robards VL, Lubin EN, Medlock TR (1975) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=1094668 Renal transplantation and placement of ileal stoma.] ''Urology'' 5 (6):787-9. PMID: [http://pubmed.gov/1094668 1094668]</ref> CT markers valid for small-airway disease can be derived from quantitative lung density measurements and these markers correlate with [[Asthma severity classification|clinical severity]], [[Asthma pulmonary function test|lung function test results]] and are also sensitive to demonstrate therapeutic effects.<ref name="pmid21742230">Laurent F, Tunon de Lara M (2011) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=21742230 Assessment of imaging techniques for evaluating small-airway disease in asthma.] ''Rev Mal Respir'' 28 (6):e7-10. [http://dx.doi.org/10.1016/j.rmr.2011.05.001 DOI:10.1016/j.rmr.2011.05.001] PMID: [http://pubmed.gov/21742230 21742230]</ref> 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 [[Asthma severity classification#Severe Persistent Asthma|severe asthma]].<ref name="pmid19542254">Gupta S, Siddiqui S, Haldar P, Raj JV, Entwisle JJ, Wardlaw AJ et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19542254 Qualitative analysis of high-resolution CT scans in severe asthma.] ''Chest'' 136 (6):1521-8. [http://dx.doi.org/10.1378/chest.09-0174 DOI:10.1378/chest.09-0174] PMID: [http://pubmed.gov/19542254 19542254]</ref> | ||
==CT== | ==CT== | ||
*Bronchial wall thickening,<ref name="pmid8351357">Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8351357 Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects.] ''Radiology'' 188 (3):829-33. PMID: [http://pubmed.gov/8351357 8351357]</ref><ref name="pmid8797980">Grenier P, Mourey-Gerosa I, Benali K, Brauner MW, Leung AN, Lenoir S et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8797980 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: [http://pubmed.gov/8797980 8797980]</ref><ref name="pmid9114089">Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9114089 Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.] ''Radiology'' 203 (2):361-7. PMID: [http://pubmed.gov/9114089 9114089]</ref> | *Bronchial wall thickening,<ref name="pmid8351357">Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8351357 Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects.] ''Radiology'' 188 (3):829-33. PMID: [http://pubmed.gov/8351357 8351357]</ref><ref name="pmid8797980">Grenier P, Mourey-Gerosa I, Benali K, Brauner MW, Leung AN, Lenoir S et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8797980 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: [http://pubmed.gov/8797980 8797980]</ref><ref name="pmid9114089">Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9114089 Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.] ''Radiology'' 203 (2):361-7. PMID: [http://pubmed.gov/9114089 9114089]</ref> | ||
*Patients with mild asthma have one or more dilated bronchi,<ref name="pmid8797980">Grenier P, Mourey-Gerosa I, Benali K, Brauner MW, Leung AN, Lenoir S et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8797980 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: [http://pubmed.gov/8797980 8797980]</ref><ref name="pmid9114089">Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9114089 Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.] ''Radiology'' 203 (2):361-7. PMID: [http://pubmed.gov/9114089 9114089]</ref> | *Patients with mild asthma have one or more dilated bronchi,<ref name="pmid8797980">Grenier P, Mourey-Gerosa I, Benali K, Brauner MW, Leung AN, Lenoir S et al. (1996) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8797980 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: [http://pubmed.gov/8797980 8797980]</ref><ref name="pmid9114089">Park CS, Müller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9114089 Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.] ''Radiology'' 203 (2):361-7. PMID: [http://pubmed.gov/9114089 9114089]</ref> | ||
*[[Bronchiectasis|Cylindrical bronchiectasis]] with the bronchoarterial- diameter ratio is less than 1.5,<ref name="pmid10724299">Mitchell TA, Hamilos DL, Lynch DA, Newell JD (2000) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10724299 Distribution and severity of bronchiectasis in allergic bronchopulmonary aspergillosis (ABPA).] ''J Asthma'' 37 (1):65-72. PMID: [http://pubmed.gov/10724299 10724299]</ref> | |||
*[[Bronchiectasis|Cylindrical bronchiectasis]] with the bronchoarterial-diameter ratio is less than 1.5,<ref name="pmid10724299">Mitchell TA, Hamilos DL, Lynch DA, Newell JD (2000) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10724299 Distribution and severity of bronchiectasis in allergic bronchopulmonary aspergillosis (ABPA).] ''J Asthma'' 37 (1):65-72. PMID: [http://pubmed.gov/10724299 10724299]</ref> | |||
*Bronchiolar mucus statis and constrictive bronchiolitis, | *Bronchiolar mucus statis and constrictive bronchiolitis, | ||
*Centrilobular opacities subsequent to bronchiolar mucus stasis or peri-bronchiolar inflammation, | *Centrilobular opacities subsequent to bronchiolar mucus stasis or peri- bronchiolar inflammation, | ||
*Areas of decreased attenuation and vascularity, as demonstrated at end-inspiration, | *Areas of decreased attenuation and vascularity, as demonstrated at end-inspiration, | ||
*[[Air trapping]], as demonstrated after maximal expiration. | *[[Air trapping]], as demonstrated after maximal expiration. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Immunology]] | [[Category:Immunology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
Latest revision as of 20:30, 29 July 2020
Asthma Microchapters |
Diagnosis |
---|
Other Diagnostic Studies |
Treatment |
Case Studies |
Asthma CT On the Web |
American Roentgen Ray Society Images of 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
- ↑ Robards VL, Lubin EN, Medlock TR (1975) Renal transplantation and placement of ileal stoma. Urology 5 (6):787-9. PMID: 1094668
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ 5.0 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
- ↑ 6.0 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
- ↑ 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