Ketai L, Coutsias C, Williamson S, Coutsias V
Department of Radiology, University of New Mexico Health Science Center, Albuquerque 87131, USA.
Acad Radiol. 2001 Mar;8(3):257-64. doi: 10.1016/S1076-6332(03)80535-4.
The authors performed this study to determine if bronchial wall thickening is present in children with moderate to severe asthma during periods free from clinical bronchoconstriction.
The authors obtained low (radiation) dose thin-section computed tomographic (CT) scans in each of 18 control subjects and 21 children with moderately severe but stable asthma. Spirometry was performed on all subjects at the time of CT scanning. Bronchial wall thickness and bronchial wall area were measured, and the percentage wall area (bronchial wall area divided by bronchial cross-sectional area) was calculated. The authors performed best-fit regression analysis of wall thickness and percentage wall area versus bronchial diameter and qualitative analysis of images for bronchial wall thickening.
In asthmatic patients, the mean percentage of the predicted forced expiratory volume in 1 second was 0.88 +/- 0.09. The best fit regression line that demonstrated the relationship between wall thickness and bronchial diameter for patients with asthma differed significantly from that for control subjects (P < .005). The regression line that demonstrated the relationship between the percentage wall area and bronchial diameter for patients with asthma differed from that of the control subjects when bronchial wall thickness measurements were used to calculate the percentage wall area (P < .05). Results of qualitative analysis also showed significantly more bronchial wall thickening in asthmatic patients than in control subjects (P < .001).
Bronchial wall thickening detected at thin-section CT in children with moderately severe asthma cannot be attributed solely to bronchoconstriction and may represent airway inflammation or remodeling.
作者开展此项研究以确定中重度哮喘患儿在无临床支气管收缩期间是否存在支气管壁增厚。
作者对18名对照受试者和21名中重度但病情稳定的哮喘患儿进行了低（辐射）剂量薄层计算机断层扫描（CT）。在进行CT扫描时，对所有受试者进行了肺功能测定。测量支气管壁厚度和支气管壁面积，并计算壁面积百分比（支气管壁面积除以支气管横截面积）。作者对壁厚度和壁面积百分比与支气管直径进行了最佳拟合回归分析，并对支气管壁增厚的图像进行了定性分析。
在哮喘患者中，预测的1秒用力呼气量的平均百分比为0.88±0.09。显示哮喘患者壁厚度与支气管直径之间关系的最佳拟合回归线与对照受试者的显著不同（P<.005）。当用支气管壁厚度测量值计算壁面积百分比时，显示哮喘患者壁面积百分比与支气管直径之间关系的回归线与对照受试者的不同（P<.05）。定性分析结果还显示，哮喘患者的支气管壁增厚明显多于对照受试者（P<.001）。
中重度哮喘患儿在薄层CT上检测到的支气管壁增厚不能仅归因于支气管收缩，可能代表气道炎症或重塑。
