HRCT und Asthma bronchiale: Visualisierung pathophysiologischer Veränderungen des Lungenparenchyms nach inhalativer Provokation

Autor: K. Sertl, H. Riemer, W. Backfrieder, C. J. Herold, B. Pittner, Thomas H. Helbich, Gerd Schueller, K. Neumann
Rok vydání: 2004
Předmět:
Zdroj: RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. 176:335-341
ISSN: 1438-9010
1438-9029
DOI: 10.1055/s-2004-812762
Popis: PURPOSE To characterize parenchymal lung affections morphologically in patients with asthma and healthy subjects by high -resolution computed tomography (HRCT) subsequent to histamine-triggered inhalation bronchoprovocation and salbutamol-induced broncholysis, and to compare the results with pulmonary function tests. MATERIALS AND METHODS Fifteen asthmatics with bronchial hyperreactivity, with a > 20% decrease in FEV1 and a > 10 mmHg decrease in PaO(2) after bronchoprovocation (PC20%+), twelve asthmatics with a 10 mmHg decrease in PaO(2) after bronchoprovocation (PC20%-), and eight healthy persons without bronchial hyperreactivity underwent inhalation bronchoprovocation and broncholysis. Spirometer-triggered HRCT at high lung volumes was performed, and total and peripheral lung densities and the amount of solid lung structures, representing predominantly vessels, were measured. RESULTS After bronchoprovocation, we observed significant decreases in total and peripheral lung densities in all groups (p 0.05), as compared to the baseline measurements. In hyperreactive patients, PaO(2) significantly decreased after provocation and significantly increased after lysis (p < 0.05). In PC20%+ asthmatics, a mean reduction of 27.8% in FEV1 was observed, which was < 20% in the other groups. No significant correlations were observed between radiological data and the results of pulmonary function tests. In healthy persons, we demonstrated highly significant parenchymal response to bronchoprovocation and broncholysis, which was not otherwise documented by pulmonary function tests. CONCLUSION In both PC20%+ and PC20%- patients as well as in healthy individuals, HRCT was efficient in the evaluation of pathoanatomical alterations of the lung parenchyma subsequent to inhalation provocation. In healthy individuals, these parenchymal alterations were not documented by pulmonary function tests.
Databáze: OpenAIRE