Thoracic and Cardiovascular Imaging Unit, Pathologic Anatomy Laboratory, Department of Functional Respiratory Exploration, Centre Hospitalier Universitaire de Bordeaux, Hopital Haut-Lévêque, 5 avenue de Magellan, 33600 Pessac, France.
Radiology. 2009 Dec;253(3):844-53. doi: 10.1148/radiol.2533090303. Epub 2009 Sep 29.
To analyze and compare computed tomographic (CT) bronchial measurements in patients with asthma and healthy subjects and to correlate bronchial morphometric parameters with functional data and immunohistologic markers of airway remodeling and inflammation.
This retrospective study was approved by the institutional review board; patient informed consent was not required. CT and pulmonary function tests were performed in 27 patients separated into two groups: 15 patients with asthma (three men; mean age, 43.1 years +/- 5.3 [standard error of mean]) and 12 healthy subjects (10 men; mean age, 45.0 years +/- 5.4). Endobronchial biopsies were performed in 11 subjects. Bronchial cross-sectional wall area (WA) and lumen area (LA) were measured by using validated software, and wall thickness (WT), total area (TA), WA/LA ratio, and WA/TA ratio were computed. Slope and maximal local slope of each parameter along bronchial generations were calculated.
Patients with asthma demonstrated significantly lower LA, TA, and WA and higher WA/LA and WA/TA ratios than healthy subjects downward from the fourth bronchial generation. Correlations existed between slope and maximal local slope of WA/LA and/or WA/TA ratios and functional data reflecting bronchial obstruction (r = 0.46-0.58, P = .001-.025), subepithelial membrane thickness (r = 0.67-0.69, P = .019-.023), smooth muscle layer area (r = 0.75, P = .007), subepithelial layer area (r = 0.81, P = .002), and infiltration of the bronchial wall by inflammatory cells (r = 0.67-0.86, P = .049-.003).
Axial reconstructions with orthogonal measurements along the airways enabled by three-dimensional segmentation methods are able to demonstrate significant changes in bronchial morphometry, predicting airflow limitation in asthma, and may have a role in the noninvasive measurement of airway remodeling.
分析比较哮喘患者和健康受试者的计算机断层扫描（CT）支气管测量值，并将支气管形态计量参数与气道重塑和炎症的功能数据和免疫组织化学标志物相关联。
本回顾性研究获得机构审查委员会批准；无需患者知情同意。对 27 例患者进行 CT 和肺功能检查，将其分为两组：15 例哮喘患者（3 名男性；平均年龄 43.1 岁 +/- 5.3[均数标准差]）和 12 例健康受试者（10 名男性；平均年龄 45.0 岁 +/- 5.4）。11 例患者进行了支气管内膜活检。使用验证软件测量支气管横截面积（WA）和管腔面积（LA），计算壁厚度（WT）、总面积（TA）、WA/LA 比值和 WA/TA 比值。计算每个参数沿支气管代际的斜率和最大局部斜率。
从第四级支气管向下，哮喘患者的 LA、TA 和 WA 显著降低，WA/LA 和 WA/TA 比值显著升高。WA/LA 和/或 WA/TA 比值的斜率和最大局部斜率与反映支气管阻塞的功能数据之间存在相关性（r = 0.46-0.58，P =.001-.025），包括上皮下膜厚度（r = 0.67-0.69，P =.019-.023）、平滑肌层面积（r = 0.75，P =.007）、上皮下层面积（r = 0.81，P =.002）和支气管壁炎症细胞浸润（r = 0.67-0.86，P =.049-.003）。
通过三维分割方法进行的气道正交测量的轴向重建能够显示支气管形态计量学的显著变化，预测哮喘患者的气流受限，并可能在气道重塑的非侵入性测量中发挥作用。
