Abstract
Background: Airway remodeling in asthma and COPD results in bronchial wall thickening. The thickness of the bronchial wall can be measured in high resolution computed tomography (HRCT). The objectives of the study were: 1) to assess the bronchial luminal and wall dimensions in asthma and COPD patients in relation to the disease severity, and 2) to compare the airway dimensions in patients with asthma and COPD.
Material and Methods: 10 asthma patients and 12 COPD patients with stable, mild to moderate disease were investigated. All patients underwent chest HRCT (window level - 450 HU, window width 1500 HU). Cross-sections of bronchi (external diameter 1.0-5.0 mm) were identified on enlarged images; the following variables were measured: external (D) and internal diameter (L), wall area (WA), lumen area (AL), total airway area (AO), WA% - the percentage of airway wall area, wall thickness (WT) and WT/D ratio. Separate sub-analyses were performed for airways with D ≤ 2.0 mm and D > 2.0 mm.
Results: 261 and 348 cross-sections of small airways were measured in patients with asthma and COPD, respectively. There was a significant difference in WT and WA which were both greater in asthmatics than in COPD patients. In bronchi with D > 2.0 mm all measured parameters were significantly higher in asthma than COPD. In individual asthmatics the airway wall thickness was similar in all the assessed bronchi, while in COPD it was related to the external airway diameter.
Conclusions: Our results indicate that bronchial walls are thicker in asthmatics than in patients with COPD. It seems that airway wall thickness and the luminal diameter in patients with asthma are related to disease severity. There is no such a relationship in COPD patients.
HRCT may be a useful tool in the assessment of airway structure in obstructive lung disease.
Footnotes
- Corresponding author Rafal Krenke MD, PhD Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Banacha 1A, 02-097 Warsaw, Poland Email. rkrenke{at}wum.edu.pl Tel. +48 225992562, +48 225992754 Fax. +48 225991560
The authors do not declare any conflict of interest
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