2006 OPEN FORUM Abstracts
CORRELATION OF HIGH RESOLUTION COMPUTED TOMOGRAPHY FINDINGS WITH DISEASE SEVERITY IN ASTHMA
Naveed Nazir Shah a MBBS
MD(student), Khurshid A Dar a MBBS MD(student), Rakesh Bhargava a MD, Zuber Ahmed a MD, Ibne Ahmad b MD, D.K Pandey a MD, Md. Shameem a MD, Arshad Altaf Bachh a MD, Md
Shamim Akhtar a MD, Inam ul Haque c MBBS MD(student)
Departments of Tuberculosis & Chest
Diseases a, Radiology b and Community Medicine c
Jawaharlal Nehru Medical College. AMU,
Aligarh, Uttar Pradesh, India 20202
e-mail: naveednazirshah@yahoomail.com Telephone: +91-9358208785
Background: The
structural changes in the airways can be assessed and quantified by high
resolution CT (HRCT). The aim of our study was to correlate the extent of
airway remodeling in vivo with the severity of asthma.
Methods: Fifty
six non smoker asthmatic patients were prospectively evaluated with HRCT.
Inspiratory CT scans were subjectively
evaluated for presence of bronchial wall thickening, bronchial hyperlucency,
linear shadows, centrilobular opacities, mucoid impaction, emphysema and
bronchiectasis. Expiratory scans were subjectively evaluated for presence of
air trapping. Asthma severity was assessed according to the International
Consensus Report as mild intermittent, mild persistant, moderate persistent and severe persistent. Statistical
analysis was done by χ2 test . A p value less than 0.05 was
considered significant.
Results: Bronchial
wall thickening was found to be the most prominent abnormality in CT scans of
asthmatics. Bronchial wall thickening, focal hyperlucency, linear opacity,
centrilobular opacities, bronchiectasis and mucoid impaction were significantly
increased in frequency with increasing severity of asthma. Emphysema and air
trapping were not found to be correlated with increased clinical severity
(Table).
| Frequencies of abnormal HRCT findings according to clinical severity groups in asthmatics | ||||||
| Mild intermittent (n=9) | Mild persistent (n=21) | Moderate persistant (n=15) | Severe persistant (n=11) | p value | ||
| Bronchial wall thickening | 2 | 14 | 14 | 11 | <0.001 | |
| Focal hyperlucency | 1 | 7 | 11 | 8 | 0.004 | |
| Thick linear opacity | 2 | 7 | 8 | 9 | 0.024 | |
| Centrilobular opacities | 1 | 5 | 8 | 7 | 0.027 | |
| Bronchiectasis | 0 | 1 | 2 | 5 | 0.008 | |
| Emphysema | 0 | 0 | 2 | 2 | 0.158 | |
| Mucoid impaction | 0 | 0 | 1 | 3 | 0.029 | |
| Air trapping | 4 | 10 | 8 | 7 | 0.808 | |
Conclusion: In
patients of asthma, the structural changes in the airways, seen on HRCT, correlate
directly with the clinical severity of the disease.