Dept of Radiology, Bichat Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
Dept of Pneumology A, Bichat Claude Bernard Hospital Assistance Publique-Hôpitaux de Paris, Paris, France.
Eur Respir J. 2017 Mar 15;49(3). doi: 10.1183/13993003.01565-2016. Print 2017 Mar.
Bronchial thermoplasty (BT) is a recent, promising and well-tolerated technique for the treatment of severe asthma. By delivering thermal energy to the airway wall, this procedure can induce early pulmonary opacities seen on computed tomography (CT). We aimed to examine early CT modifications induced by BT and to determine their association with respiratory symptoms.Unenhanced chest CT was performed the day after each BT session in 13 patients with severe asthma, leading to the examination of 38 treated lobes. A total of 15 BT-treated lobes were evaluated in 11 patients at 1 month. The first two patients also underwent CT at 1 week.No symptoms suggestive of pulmonary infection were noted following BT in any patient. Peribronchial consolidations and ground-glass opacities were observed in all treated lobes on day 1, with three lower lobes showing complete collapse. Mild involvement of an adjacent untreated lobe was observed in 12 out of 38 (32%) cases. Opacities had decreased in 5 out of 15 (33%) and disappeared in 10 out of 15 (67%) at 1 month.BT induced early pulmonary peribronchial hyperdensities in all treated lobes. These alterations were unrelated to clinical symptoms and spontaneously decreased or disappeared after 1 month.
支气管热成形术（BT）是一种治疗严重哮喘的新技术，具有良好的耐受性。通过向气道壁输送热能，该程序可以诱导计算机断层扫描（CT）上可见的早期肺部混浊。我们旨在检查 BT 诱导的早期 CT 改变，并确定其与呼吸症状的关系。在 13 例严重哮喘患者每次 BT 治疗后一天进行未增强胸部 CT 检查，共检查了 38 个治疗的肺叶。在 11 例患者中，有 15 个 BT 治疗的肺叶在 1 个月时进行了评估。前两名患者还在 1 周时进行了 CT 检查。在任何患者中，BT 后均未出现提示肺部感染的症状。在第 1 天，所有治疗的肺叶均观察到支气管周围实变和磨玻璃影，3 个下肺叶完全塌陷。在 38 个肺叶中有 12 个（32%）观察到相邻未治疗肺叶的轻度受累。在 15 个肺叶中有 5 个（33%）的混浊减少，10 个（67%）在 1 个月时消失。BT 在所有治疗的肺叶中均引起早期肺部支气管周围高密度影。这些改变与临床症状无关，在 1 个月后自行减少或消失。
