Allergy Asthma Immunol Res.  2011 Apr;3(2):111-117. 10.4168/aair.2011.3.2.111.

Airway Measurement for Airway Remodeling Defined by Post-Bronchodilator FEV1/FVC in Asthma: Investigation Using Inspiration-Expiration Computed Tomography

Affiliations
  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. seojb@amc.seoul.kr
  • 2Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Allergy, Haeundae Paik Hospital, Inje University, Busan, Korea.

Abstract

PURPOSE
Airway remodeling may be responsible for irreversible airway obstruction in asthma, and a low post-bronchodilator FEV1/FVC ratio can be used as a noninvasive marker of airway remodeling. We investigated correlations between airway wall indices on computed tomography (CT) and various clinical indices, including post-bronchodilator FEV1/FVC ratio, in patients with asthma.
METHODS
Volumetric CT was performed on 22 stable asthma patients who were taking inhaled corticosteroids. Airway dimensions were measured at four segmental bronchi using in-house software based on the full-width/half-maximum method. Parameters included luminal area, wall thickness (WT), wall thickness percentage (WT%), wall area percentage (WA%), bronchial-to-arterial diameter (BA) ratio on inspiration CT, airway collapsibility (AC), and air trapping index (ATI). Correlations were analyzed between CT parameters and clinical indices, including %FEV1, FEV1/FVC, FEF25-75%, and post-bronchodilator FEV1/FVC ratio.
RESULTS
Post-bronchodilator FEV1/FVC showed significant correlations with WT%, WT, BA ratio, AC, and ATI (r=-0.503, -0.576, 0.454, 0.475, and -0.610, respectively). WT showed negative correlations with FEV1/FVC and FEF25-75% (r=-0.431 and -0.581), and WT% was negatively correlated with %FEV1, FEV1/FVC, and FEF25-75% (r=-0.434, -0.431, and -0.540, respectively). WA% showed correlations with FEF25-75% and body mass index (r=-0.459 and 0.453). The BA ratio was positively correlated with %FEV1 (r=0.459) and FEF25-75% (r=0.479). AC showed strong positive correlation with FEV1/FVC (r=0.592), and ATI showed negative correlations with FEV1/FVC (r=-0.534) and FEF25-75% (r=-0.591).
CONCLUSIONS
WT%, WT, BA ratio, and AC on inspiration and expiration CT are good indices for measuring airway remodeling defined by post-bronchodilator FEV1/FVC in stable asthma patients treated with inhaled corticosteroids.

Keyword

Asthma; airway remodeling; postbronchodilator FEV1/FVC ratio

MeSH Terms

Adrenal Cortex Hormones
Airway Obstruction
Airway Remodeling
Asthma
Body Mass Index
Bronchi
Cone-Beam Computed Tomography
Humans
Phenobarbital
Adrenal Cortex Hormones
Phenobarbital

Figure

  • Figure Measurement of airway dimensions. This image briefly shows the process of measuring the airway dimensions using our in-house software. After the selection of a segmental bronchus, the data regarding airway dimensions were automatically obtained.


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