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Radiologic Diagnostic Modalities in Severe Asthma

  • Gong Yong Jin
Chapter

Abstract

Asthma is one of the most prevalent lung diseases. In asthma, airway inflammation leads to airway remodeling, and airway remodeling contributes to the lung parenchyma remodeling. High-resolution computed tomography (HRCT) has been widely used as an imaging tool for asthma. Technical advances in CT coupled with the development of analysis software have enabled the quantitative analysis of lung parenchymal changes and airway remodeling using CT. This article reviews the role of CT in assessing lung structure in patients with asthma.

Keywords

Asthma Computed tomography (CT) Airway remodeling Parenchymal lung disease 

References

  1. 1.
    Bousquet J, Chanez P, Lacoste JY, Barneon G, Ghavanian N, Enander I, et al. Eosinophilic inflammation in asthma. N Engl J Med. 1990;323(15):1033–9.CrossRefPubMedGoogle Scholar
  2. 2.
    Park CS, Muller NL, Worthy SA, Kim JS, Awadh N, FitzGerald M. Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings. Radiology. 1997;203(2):361–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Wenzel S. Severe asthma in adults. Am J Respir Crit Care Med. 2005;172(2):149–60.CrossRefPubMedGoogle Scholar
  4. 4.
    FitzGerald JM, Bateman E, Hurd S, Boulet LP, Haahtela T, Cruz AA, et al. The GINA asthma challenge: reducing asthma hospitalisations. Eur Respir J. 2011;38(5):997–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Niimi A, Matsumoto H, Takemura M, Ueda T, Nakano Y, Mishima M. Clinical assessment of airway remodeling in asthma: utility of computed tomography. Clin Rev Allergy Immunol. 2004;27(1):45–58.CrossRefPubMedGoogle Scholar
  6. 6.
    Paganin F, Trussard V, Seneterre E, Chanez P, Giron J, Godard P, et al. Chest radiography and high resolution computed tomography of the lungs in asthma. Am Rev Respir Dis. 1992;146(4):1084–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Webb WR. High-resolution computed tomography of obstructive lung disease. Radiol Clin N Am. 1994;32(4):745–57.PubMedGoogle Scholar
  8. 8.
    Harmanci E, Kebapci M, Metintas M, Ozkan R. High-resolution computed tomography findings are correlated with disease severity in asthma. Respiration. 2002;69(5):420–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Gupta S, Siddiqui S, Haldar P, Entwisle JJ, Mawby D, Wardlaw AJ, et al. Quantitative analysis of high-resolution computed tomography scans in severe asthma subphenotypes. Thorax. 2010;65(9):775–81.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Carr DH, Hibon S, Rubens M, Chung KF. Peripheral airways obstruction on high-resolution computed tomography in chronic severe asthma. Respir Med. 1998;92(3):448–53.CrossRefPubMedGoogle Scholar
  11. 11.
    Witt CA, Sheshadri A, Carlstrom L, Tarsi J, Kozlowski J, Wilson B, et al. Longitudinal changes in airway remodeling and air trapping in severe asthma. Acad Radiol. 2014;21(8):986–93.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Bumbacea D, Campbell D, Nguyen L, Carr D, Barnes PJ, Robinson D, et al. Parameters associated with persistent airflow obstruction in chronic severe asthma. Eur Respir J. 2004;24(1):122–8.CrossRefPubMedGoogle Scholar
  13. 13.
    Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R. Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology. 1993;188(3):829–33.CrossRefPubMedGoogle Scholar
  14. 14.
    Choi S, Hoffman EA, Wenzel SE, Tawhai MH, Yin Y, Castro M, et al. Registration-based assessment of regional lung function via volumetric CT images of normal subjects vs. severe asthmatics. J Appl Physiol (1985). 2013;115(5):730–42.CrossRefGoogle Scholar
  15. 15.
    Busacker A, Newell JD Jr, Keefe T, Hoffman EA, Granroth JC, Castro M, et al. A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest. 2009;135(1):48–56.CrossRefPubMedGoogle Scholar
  16. 16.
    Fain SB, Gonzalez-Fernandez G, Peterson ET, Evans MD, Sorkness RL, Jarjour NN, et al. Evaluation of structure-function relationships in asthma using multidetector CT and hyperpolarized He-3 MRI. Acad Radiol. 2008;15(6):753–62.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Dunnill MS, Massarella GR, Anderson JA. A comparison of the quantitative anatomy of the bronchi in normal subjects, in status asthmaticus, in chronic bronchitis, and in emphysema. Thorax. 1969;24(2):176–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Awadh N, Muller NL, Park CS, Abboud RT, FitzGerald JM. Airway wall thickness in patients with near fatal asthma and control groups: assessment with high resolution computed tomographic scanning. Thorax. 1998;53(4):248–53.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Okazawa M, Muller N, McNamara AE, Child S, Verburgt L, Pare PD. Human airway narrowing measured using high resolution computed tomography. Am J Respir Crit Care Med. 1996;154(5):1557–62.CrossRefPubMedGoogle Scholar
  20. 20.
    James AL, Pare PD, Hogg JC. The mechanics of airway narrowing in asthma. Am Rev Respir Dis. 1989;139(1):242–6.CrossRefPubMedGoogle Scholar
  21. 21.
    Little SA, Sproule MW, Cowan MD, Macleod KJ, Robertson M, Love JG, et al. High resolution computed tomographic assessment of airway wall thickness in chronic asthma: reproducibility and relationship with lung function and severity. Thorax. 2002;57(3):247–53.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Park JW, Hong YK, Kim CW, Kim DK, Choe KO, Hong CS. High-resolution computed tomography in patients with bronchial asthma: correlation with clinical features, pulmonary functions and bronchial hyperresponsiveness. J Investig Allergol Clin Immunol. 1997;7(3):186–92.PubMedGoogle Scholar
  23. 23.
    Moore WC, Bleecker ER, Curran-Everett D, Erzurum SC, Ameredes BT, Bacharier L, et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol. 2007;119(2):405–13.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Moore WC, Meyers DA, Wenzel SE, Teague WG, Li H, Li X, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010;181(4):315–23.CrossRefPubMedGoogle Scholar
  25. 25.
    Jarjour NN, Erzurum SC, Bleecker ER, Calhoun WJ, Castro M, Comhair SA, et al. Severe asthma: lessons learned from the National Heart, Lung, and Blood Institute Severe Asthma Research Program. Am J Respir Crit Care Med. 2012;185(4):356–62.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Walker C, Gupta S, Hartley R, Brightling CE. Computed tomography scans in severe asthma: utility and clinical implications. Curr Opin Pulm Med. 2012;18(1):42–7.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Brown MS, Kim HJ, Abtin F, Da Costa I, Pais R, Ahmad S, et al. Reproducibility of lung and lobar volume measurements using computed tomography. Acad Radiol. 2010;17(3):316–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Sorkness RL, Bleecker ER, Busse WW, Calhoun WJ, Castro M, Chung KF, et al. Lung function in adults with stable but severe asthma: air trapping and incomplete reversal of obstruction with bronchodilation. J Appl Physiol (1985). 2008;104(2):394–403.CrossRefGoogle Scholar
  29. 29.
    Gupta S, Siddiqui S, Haldar P, Raj JV, Entwisle JJ, Wardlaw AJ, et al. Qualitative analysis of high-resolution CT scans in severe asthma. Chest. 2009;136(6):1521–8.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    de Jong PA, Muller NL, Pare PD, Coxson HO. Computed tomographic imaging of the airways: relationship to structure and function. Eur Respir J. 2005;26(1):140–52.CrossRefPubMedGoogle Scholar
  31. 31.
    Aysola RS, Hoffman EA, Gierada D, Wenzel S, Cook-Granroth J, Tarsi J, et al. Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology. Chest. 2008;134(6):1183–91.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Chiro GD, Brooks RA, Kessler RM, et al. Tissue signatures with dual-energy computed tomography. Radiology. 1979;131:521–3.CrossRefPubMedGoogle Scholar
  33. 33.
    Chae EJ, Seo JB, Lee J, et al. Xenon ventilation imaging using dual-energy computed tomography in asthmatics: initial experience. Investig Radiol. 2010;45:354–61.Google Scholar
  34. 34.
    Kong X, Sheng HX, Lu GM, Meinel FG, Dyer KT, Schoepf UJ, et al. Xenon-enhanced dual-energy CT lung ventilation imaging: techniques and clinical applications. AJR Am J Roentgenol. 2014;202(2):309–17.CrossRefPubMedGoogle Scholar
  35. 35.
    Jung JW, Kwon JW, Kim TW, Lee SH, Kim KM, Kang HR, et al. New insight into the assessment of asthma using xenon ventilation computed tomography. Ann Allergy Asthma Immunol. 2013;111(2):90–5.CrossRefPubMedGoogle Scholar
  36. 36.
    Altes TA, Powers PL, Knight-Scott J, Rakes G, Platts-Mills TAE, de Lange EE, et al. Hyperpolarized 3He MR lung ventilation imaging in asthmatics: preliminary findings. J Magn Reson Imaging. 2001;13:378–84.CrossRefPubMedGoogle Scholar
  37. 37.
    Hahn AD, Cadman RV, Sorkness RL, Jarjour NN, Nagle SK, Fain SB. Redistribution of inhaled hyperpolarized 3He gas during breath-hold differs by asthma severity. J Appl Physiol. 2016;120(5):526–36.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of RadiologyChonbuk National University Medical SchoolJeonjuSouth Korea

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