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Quantitative analysis of dynamic airway changes after methacholine and salbutamol inhalation on xenon-enhanced chest CT

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Abstract

Objectives

To investigate the dynamic changes in airways in response to methacholine and salbutamol inhalation and to correlate the xenon ventilation index on xenon-enhanced chest CTs in asthmatics.

Methods

Thirty-one non-smokers (6 normal, 25 asthmatics) underwent xenon-enhanced chest CT and pulmonary function tests. Images were obtained at three stages (basal state, after methacholine inhalation and after salbutamol inhalation), and the total xenon ventilation index (TXVI) as well as airway values were measured and calculated. The repeated measures ANOVA and Spearman’s correlation coefficient were used for statistical analysis.

Results

TXVI in the normal group did not significantly change (P > 0.05) with methacholine and salbutamol. For asthmatics, however, the TXVI significantly decreased after methacholine inhalation and increased after salbutamol inhalation (P < 0.05). Of the airway parameters, the airway inner area (IA) significantly increased after salbutamol inhalation in all airways (P < 0.01) in asthmatics. Airway IA, wall thickness and wall area percentage did not significantly decrease after methacholine inhalation (P > 0.05). IA of the large airways was well correlated with basal TXVI, FEV1 and FVC (P < 0.05).

Conclusions

Airway IA is the most reliable parameter for reflecting the dynamic changes after methacholine and salbutamol inhalation, and correlates well with TXVI in asthmatics on xenon-enhanced CT.

Key Points

• In asthmatics, xenon ventilation decreases after methacholine and increases after salbutamol inhalation.

• Inner airway area (IA) correlates well with xenon ventilation.

• IA is the most reliable parameter reflecting airway changes in drug responses.

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Abbreviations

CTDI:

CT dose index

DLP:

dose length product

FEV1 :

forced expiratory volume in 1 s

FVC:

forced vital capacity

IA:

inner area

LMB:

left main bronchus

PFTs:

pulmonary function tests

RMB:

right main bronchus

TXVI:

total xenon ventilation index

WA%:

wall area percentage

WT:

wall thickness

WVI:

weighted ventilation index

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Acknowledgements

This study was supported by a grant of the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (A0810347).

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Authors and Affiliations

  1. Department of Radiology, Seoul National University College of Medicine, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea

    Sang Joon Park, Chang Hyun Lee, Jin Mo Goo, Jong Hyo Kim & Eun-Ah Park

  2. Institute of Radiation Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea

    Sang Joon Park, Chang Hyun Lee, Jin Mo Goo, Jong Hyo Kim & Eun-Ah Park

  3. Seoul National University Hospital, Healthcare Gangnam Center, Seoul, Korea

    Chang Hyun Lee & Sang-Heon Cho

  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Jae-Woo Jung, Heung-Woo Park & Sang-Heon Cho

  5. Institute of Allergy and Clinical Immunology, Seoul National University College of Medicine, Seoul, Korea

    Jae-Woo Jung, Heung-Woo Park & Sang-Heon Cho

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  1. Sang Joon Park
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  2. Chang Hyun Lee
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  3. Jin Mo Goo
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Corresponding author

Correspondence to Chang Hyun Lee.

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Park, S.J., Lee, C.H., Goo, J.M. et al. Quantitative analysis of dynamic airway changes after methacholine and salbutamol inhalation on xenon-enhanced chest CT. Eur Radiol 22, 2441–2450 (2012). https://doi.org/10.1007/s00330-012-2516-0

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  • DOI: https://doi.org/10.1007/s00330-012-2516-0

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