Quantitative CT detects changes in airway dimensions and air-trapping after bronchial thermoplasty for severe asthma
| Autor: | Claus P. Heussel, Oliver Weinheimer, Maren Schuhmann, Mark O. Wielpütz, Willi L. Wagner, Philine Kaukel, Philip Konietzke, Ralf Eberhardt, Hans-Ulrich Kauczor, Felix J.F. Herth |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Bronchi Air trapping 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine Hounsfield scale Humans Medicine Body Weights and Measures Radiology Nuclear Medicine and imaging Expiration Lung Retrospective Studies Asthma Bronchial Thermoplasty Bronchial thermoplasty business.industry General Medicine Middle Aged respiratory system medicine.disease respiratory tract diseases medicine.anatomical_structure 030228 respiratory system Evaluation Studies as Topic Cardiology Female Bronchoconstriction medicine.symptom Tomography X-Ray Computed business Airway |
| Zdroj: | European Journal of Radiology. 107:33-38 |
| ISSN: | 0720-048X |
| Popis: | Bronchial thermoplasty (BT) can be considered in the treatment of severe asthma to reduce airway smooth muscle mass and bronchoconstriction. We hypothesized that BT may thus have long-term effects on airway dimensions and air-trapping detectable by quantitative computed tomography (QCT).Paired in- and expiratory CT and inspiratory CT were acquired in 17 patients with severe asthma before and up to two years after bronchial thermoplasty and in 11 additional conservatively treated patients with serve asthma, respectively. A fully automatic software calculated the airways metrics for wall thickness (WT), wall percentage (WP), lumen area (LA) and total diameter (TD). Furthermore, lung air-trapping was quantified by determining the quotient of mean lung attenuation in expiration vs. inspiration (E/I MLA) and relative volume change in the Hounsfield interval -950 to -856 in expiration to inspiration (RVCBT reduced WT for the combined analysis of the 2nd-7th airway generation significantly by 0.06 mm (p = 0.026) and WP by 2.05% (p 0.001), whereas LA and TD did not change significantly (p = 0.147, p = 0.706). No significant changes were found in the control group. Furthermore, E/I MLA and RVCBT significantly reduced airway narrowing and air-trapping in patients with severe asthma. This can be interpreted as direct therapeutic effects caused by a reduction in airway-smooth muscle mass and changes in innervation. A reduction in air-trapping indicates an influence on more peripheral airways not directly treated by the BT procedure. |
| Databáze: | OpenAIRE |
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