The Science Journal of the American Association for Respiratory Care

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.

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