Quantitative computed tomography detects peripheral airway disease in asthmatic children
Article first published online: 13 JUL 2005
Copyright © 2005 Wiley-Liss, Inc.
Volume 40, Issue 3, pages 211–218, September 2005
How to Cite
Jain, N., Covar, R. A., Gleason, M. C., Newell, J. D., Gelfand, E. W. and Spahn, J. D. (2005), Quantitative computed tomography detects peripheral airway disease in asthmatic children. Pediatr. Pulmonol., 40: 211–218. doi: 10.1002/ppul.20215
- Issue published online: 27 JUL 2005
- Article first published online: 13 JUL 2005
- Manuscript Accepted: 11 FEB 2005
- Manuscript Received: 16 JUL 2004
- Manuscript Revised: 16 JAN 2004
- Medical School Research Grant, Merck and Co., Inc
- quantitative computed tomography;
- peripheral airway disease;
- lung function tests
The aim of this study was to compare air-trapping as quantified by high-resolution computed tomography (HRCT) of the chest with measures of lung function and airway inflammation in children with mild to moderate asthma. Plethysmography indices, respiratory resistance, and reactance before and after bronchodilator with impulse oscillation (IOS), exhaled nitric oxide (eNO), total eosinophil count (TEC), and serum eosinophil cationic protein (ECP) levels were measured in 21 subjects. A single-cut HRCT image at end-expiration was obtained. Air-trapping was quantified and expressed in terms of the pixel index (PI) by determining the percentage of pixels in lung fields below −856 and −910 Hounsfeld units (HU). Pairwise linear correlations between PI and other parameters were evaluated. Subjects had only mild airflow limitation based on prebronchodilator forced expiratory volume in 1 sec (FEV1), but were hyperinflated and had air-trapping based on elevated total lung capacity (TLC) and residual volume (RV)/TLC ratio, respectively. The PI at −856 HU was positively correlated with % predicted TLC, total gas volume (TGV), and ECP level, and was inversely correlated with FEV1/forced vital capacity (FVC) and % predicted forced expiratory flow between 25–75% FVC (FEF25–75). The PI at −910 HU correlated similarly with these variables, and also correlated positively with IOS bronchodilator reversibility. This data suggest that quantitative HRCT may be a useful tool in the evaluation of peripheral airflow obstruction in children with asthma. Pediatr Pulmonol. © 2005 Wiley-Liss, Inc.