Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology.
Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology.
复制标题
作者：
Aysola RS;Hoffman EA;Gierada D;Wenzel S;Cook-Granroth J;Tarsi J;Zheng J;Schechtman KB;Ramkumar TP;Cochran R;Xueping E;Christie C;Newell J;Fain S;Altes TA;Castro M
前瞻性应用自动化、定量3-D方法进行成像和气道分析，以评估哮喘的气道重塑。使用肺部工作站（维达诊断），能够对低剂量、薄切片进行定量气道段测量（0.625-1.25 mm）多排螺旋CT（MDCT），我们比较了123名参与前瞻性多中心队列研究NIH重度哮喘研究项目（SARP）的受试者的气道壁厚度（WT）和面积（WA）：重度哮喘63例，轻中度哮喘35例，正常25例。这些受试者的一个子集接受了纤维支气管镜检查和支气管内活检（n=32）。WT和WA根据总气道直径和面积进行校正- WT%，WA%。重度哮喘受试者的WT%显著高于轻中度哮喘和正常受试者[分别为17.2±1.5 v 16.5±1.6，p=0.014和16.3±1.2，p=0.031]，WA%显著高于轻中度哮喘和正常受试者[分别为56.6±2.9 v 54.7±3.3，p= 0.005和54.6±2.4，p=0.003，分别）。WT%和WA%均与基线FEV1%呈负相关（分别为r=-0.39，p<0.0001和-0.40，p<0.0001），与支气管扩张剂反应呈正相关（分别为r=0.28，p=0.002和r=0.35，p<0.0001）。活检时的气道上皮厚度与WT%（r=0.47，p=0.007）和WA%（r=0.52，p=0.003）相关。在同一个体中，气道壁厚度存在相当大的区域异质性。重度哮喘患者在MDCT上的气道壁比轻度哮喘患者或正常人厚，这与气道重塑的病理指标和气流阻塞的程度相关。MDCT可能是评估哮喘气道重塑的有用技术，但组间重叠限制了个体受试者的诊断价值。
To prospectively apply an automated, quantitative 3-D approach to imaging and airway analysis to assess airway remodeling in asthma. Using the Pulmonary Workstation (VIDA Diagnostics) that enables quantitative airway segment measurements of low-dose, thin section (0.625-1.25 mm) multidetector-row CT (MDCT), we compared airway wall thickness (WT) and area (WA) in 123 subjects participating in a prospective multicenter cohort study, NIH Severe Asthma Research Program (SARP): severe asthma (n=63), mild-moderate asthma (n=35), and normal (n=25). A subset of these subjects underwent fiberoptic bronchoscopy and endobronchial biopsies (n=32). WT and WA were corrected for total airway diameter and area - WT%, WA%. Subjects with severe asthma had significantly greater WT% than mild-moderate asthma and normals [17.2±1.5 v 16.5±1.6, p=0.014 and 16.3±1.2, p=0.031, respectively] and greater WA% compared to mild-moderate asthma and normal [56.6±2.9 v 54.7±3.3, p=.005 and 54.6±2.4, p=0.003, respectively]. Both WT% and WA% were inversely correlated with baseline FEV1% (r=-0.39, p<0.0001 and -0.40, p<0.0001, respectively) and positively correlated with response to bronchodilator (r=0.28, p=0.002 and r=0.35, p<0.0001, respectively). Airway epithelial thickness on biopsy correlated with WT% (r=0.47, p=0.007) and WA% (r=0.52, p=0.003). In the same individual, there is considerable regional heterogeneity in airway wall thickness. Severe asthmatics have thicker airway walls on MDCT than mild asthmatics or normals, which correlates with pathologic measures of remodeling and the degree of airflow obstruction. MDCT may be a useful technique for assessing airway remodeling in asthma, but overlap among groups limits the diagnostic value in individual subjects.
登录
查看更多内容
影响因子：
4.8
作者：
Ketai, L;Coutsias, C;Coutsias, V
通讯作者：
Coutsias, V
DOI：
10.1164/ajrccm/147.2.405
发表时间：
1993-02-01
期刊：
AMERICAN REVIEW OF RESPIRATORY DISEASE
影响因子：
--
作者：
CARROLL, N;ELLIOT, J;JAMES, A
通讯作者：
JAMES, A
影响因子：
24.3
作者：
Miller, MR;Hankinson, J;Wanger, J
通讯作者：
Wanger, J
影响因子：
10
作者：
Kasahara, K;Shiba, K;Adachi, M
通讯作者：
Adachi, M
影响因子：
10.6
作者：
Tschirren, J;Hoffman, EA;Sonka, M
通讯作者：
Sonka, M