Lynch D A
Department of Radiology, University of Colorado Health Sciences Center, USA.
Radiol Clin North Am. 1998 Jan;36(1):129-42. doi: 10.1016/s0033-8389(05)70010-5.
The chest radiograph of the patient with asthma is characterized by bronchial wall thickening and hyperinflation. On CT scanning of patients with asthma one may see airway wall thickening, thickened centrilobular structures, and focal or diffuse hyperlucency. Apparent bronchial dilation may be seen, but the diagnosis of bronchiectasis should be made with caution. Quantification of changes in the airway wall and lung parenchyma may be valuable in understanding the mechanisms of asthma and in evaluating the effects of treatment. Central bronchiectasis occurs in most, but not all, cases of ABPA. Patchy airspace opacity may be the sole radiologic manifestation of ABPA in some cases. Other fungi can rarely cause a similar syndrome. The challenge for the radiologist evaluating the images of a patient with asthma is to find complications, such as ABPA, or alternative diagnoses.
哮喘患者的胸部X光片特征为支气管壁增厚和肺过度充气。在哮喘患者的CT扫描中，可见气道壁增厚、小叶中心结构增厚以及局灶性或弥漫性透亮增强。可能会出现明显的支气管扩张，但诊断支气管扩张时应谨慎。气道壁和肺实质变化的量化对于理解哮喘机制和评估治疗效果可能具有重要价值。大多数（但并非所有）变应性支气管肺曲霉菌病（ABPA）病例会出现中心性支气管扩张。在某些情况下，斑片状气腔模糊可能是ABPA唯一的放射学表现。其他真菌很少能引起类似综合征。放射科医生在评估哮喘患者的影像时面临的挑战是发现并发症，如ABPA，或其他诊断。
