| High resolution computed tomographic assessment of airway remodeling: comparison according to the severity of asthma |
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Seong Yong Lim, Yang Soo Kim, Byoung Whui Choi |
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한림대학교 의과대학 춘천성심병원 내과, 산부인과1 |
| 원저 : HRCT를 이용한 천식의 중증도에 따른 기도개형의 평가 |
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임성용&#;김양수&#;최병휘, Yang Soo Kim, Byoung Whui Choi |
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| Abstract |
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Background : Airway remodeling is characterized by an increase in the airway wall thickness. We aimed to compare the airway wall thickness among asthmatic subjects with different severity and to examine its relation to pulmonary function and airway hyperresponsiveness.
Methods : Thirty-seven adult asthmatics were assigned to mild (MA, n=17), moderate (MoA, n=11), and severe (SA, n=9) groups according to the Global Initiative for Asthma classification. Patients with more than 10 pack-years of smoking history were excluded. We measured the airway wall thickness (T) and internal diameter (d) using high-resolution computed tomography, and then calculated the external diameter (D). The T/D ratio was compared between the groups and correlations between the T/D ratio and pulmonary function (methacholine PC20) were assessed.
Results : The mean T/D ratio was significantly higher in the MoA and the SA groups than in the MA group for the total airways (0.278¡¾0.014, 0.281¡¾0 .019 vs. 0.228¡¾0.013; p=0.022, p=0.021, respectively). The mean T/D ratio was also higher in the SA group than the MA group for the small airways (0.313¡¾0.018 vs. 0.253¡¾0.013; p=0.009). However, there were no significant differences for the large airways. The mean T/D ratio negatively correlated with FEV1 (L) and FEV1 (% of predicted) in total airways (r=-0.519, p=0.001; r=-0.396, p=0.015), small airways (r=-0.567, p<0.001; r=-0.450, p=0.008) and large airways (r=-0.395, p=0.015; r=-0.351, p=0.033). The methacholine PC20 was not related to the T/D ratio.
Conclusions : This study suggests that patients with moderate to severe asthma have greater airway remodeling than those with mild asthma, and the degree of airway wall thickening correlates to the severity of airflow obstruction. (Korean J Med 73:631-637, 2007)
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| Key Words:
Airway remodeling, Airway wall thickness, Bronchial asthma, High-resolution computed tomography, Pulmonary function |
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