Skip to main content

Radiologic Diagnostic Modalities in Severe Asthma

  • Chapter
  • First Online:
Book cover Severe Asthma
  • 847 Accesses

Abstract

Asthma is one of the most prevalent lung diseases. In asthma, airway inflammation leads to airway remodeling, and airway remodeling contributes to the lung parenchyma remodeling. High-resolution computed tomography (HRCT) has been widely used as an imaging tool for asthma. Technical advances in CT coupled with the development of analysis software have enabled the quantitative analysis of lung parenchymal changes and airway remodeling using CT. This article reviews the role of CT in assessing lung structure in patients with asthma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bousquet J, Chanez P, Lacoste JY, Barneon G, Ghavanian N, Enander I, et al. Eosinophilic inflammation in asthma. N Engl J Med. 1990;323(15):1033–9.

    Article  CAS  PubMed  Google Scholar 

  2. Park CS, Muller NL, Worthy SA, Kim JS, Awadh N, FitzGerald M. Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings. Radiology. 1997;203(2):361–7.

    Article  CAS  PubMed  Google Scholar 

  3. Wenzel S. Severe asthma in adults. Am J Respir Crit Care Med. 2005;172(2):149–60.

    Article  PubMed  Google Scholar 

  4. FitzGerald JM, Bateman E, Hurd S, Boulet LP, Haahtela T, Cruz AA, et al. The GINA asthma challenge: reducing asthma hospitalisations. Eur Respir J. 2011;38(5):997–8.

    Article  CAS  PubMed  Google Scholar 

  5. Niimi A, Matsumoto H, Takemura M, Ueda T, Nakano Y, Mishima M. Clinical assessment of airway remodeling in asthma: utility of computed tomography. Clin Rev Allergy Immunol. 2004;27(1):45–58.

    Article  PubMed  Google Scholar 

  6. Paganin F, Trussard V, Seneterre E, Chanez P, Giron J, Godard P, et al. Chest radiography and high resolution computed tomography of the lungs in asthma. Am Rev Respir Dis. 1992;146(4):1084–7.

    Article  CAS  PubMed  Google Scholar 

  7. Webb WR. High-resolution computed tomography of obstructive lung disease. Radiol Clin N Am. 1994;32(4):745–57.

    CAS  PubMed  Google Scholar 

  8. Harmanci E, Kebapci M, Metintas M, Ozkan R. High-resolution computed tomography findings are correlated with disease severity in asthma. Respiration. 2002;69(5):420–6.

    Article  PubMed  Google Scholar 

  9. Gupta S, Siddiqui S, Haldar P, Entwisle JJ, Mawby D, Wardlaw AJ, et al. Quantitative analysis of high-resolution computed tomography scans in severe asthma subphenotypes. Thorax. 2010;65(9):775–81.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Carr DH, Hibon S, Rubens M, Chung KF. Peripheral airways obstruction on high-resolution computed tomography in chronic severe asthma. Respir Med. 1998;92(3):448–53.

    Article  CAS  PubMed  Google Scholar 

  11. Witt CA, Sheshadri A, Carlstrom L, Tarsi J, Kozlowski J, Wilson B, et al. Longitudinal changes in airway remodeling and air trapping in severe asthma. Acad Radiol. 2014;21(8):986–93.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Bumbacea D, Campbell D, Nguyen L, Carr D, Barnes PJ, Robinson D, et al. Parameters associated with persistent airflow obstruction in chronic severe asthma. Eur Respir J. 2004;24(1):122–8.

    Article  CAS  PubMed  Google Scholar 

  13. Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R. Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology. 1993;188(3):829–33.

    Article  CAS  PubMed  Google Scholar 

  14. Choi S, Hoffman EA, Wenzel SE, Tawhai MH, Yin Y, Castro M, et al. Registration-based assessment of regional lung function via volumetric CT images of normal subjects vs. severe asthmatics. J Appl Physiol (1985). 2013;115(5):730–42.

    Article  Google Scholar 

  15. Busacker A, Newell JD Jr, Keefe T, Hoffman EA, Granroth JC, Castro M, et al. A multivariate analysis of risk factors for the air-trapping asthmatic phenotype as measured by quantitative CT analysis. Chest. 2009;135(1):48–56.

    Article  PubMed  Google Scholar 

  16. Fain SB, Gonzalez-Fernandez G, Peterson ET, Evans MD, Sorkness RL, Jarjour NN, et al. Evaluation of structure-function relationships in asthma using multidetector CT and hyperpolarized He-3 MRI. Acad Radiol. 2008;15(6):753–62.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Dunnill MS, Massarella GR, Anderson JA. A comparison of the quantitative anatomy of the bronchi in normal subjects, in status asthmaticus, in chronic bronchitis, and in emphysema. Thorax. 1969;24(2):176–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Awadh N, Muller NL, Park CS, Abboud RT, FitzGerald JM. Airway wall thickness in patients with near fatal asthma and control groups: assessment with high resolution computed tomographic scanning. Thorax. 1998;53(4):248–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Okazawa M, Muller N, McNamara AE, Child S, Verburgt L, Pare PD. Human airway narrowing measured using high resolution computed tomography. Am J Respir Crit Care Med. 1996;154(5):1557–62.

    Article  CAS  PubMed  Google Scholar 

  20. James AL, Pare PD, Hogg JC. The mechanics of airway narrowing in asthma. Am Rev Respir Dis. 1989;139(1):242–6.

    Article  CAS  PubMed  Google Scholar 

  21. Little SA, Sproule MW, Cowan MD, Macleod KJ, Robertson M, Love JG, et al. High resolution computed tomographic assessment of airway wall thickness in chronic asthma: reproducibility and relationship with lung function and severity. Thorax. 2002;57(3):247–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Park JW, Hong YK, Kim CW, Kim DK, Choe KO, Hong CS. High-resolution computed tomography in patients with bronchial asthma: correlation with clinical features, pulmonary functions and bronchial hyperresponsiveness. J Investig Allergol Clin Immunol. 1997;7(3):186–92.

    CAS  PubMed  Google Scholar 

  23. Moore WC, Bleecker ER, Curran-Everett D, Erzurum SC, Ameredes BT, Bacharier L, et al. Characterization of the severe asthma phenotype by the National Heart, Lung, and Blood Institute’s Severe Asthma Research Program. J Allergy Clin Immunol. 2007;119(2):405–13.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Moore WC, Meyers DA, Wenzel SE, Teague WG, Li H, Li X, et al. Identification of asthma phenotypes using cluster analysis in the Severe Asthma Research Program. Am J Respir Crit Care Med. 2010;181(4):315–23.

    Article  PubMed  Google Scholar 

  25. Jarjour NN, Erzurum SC, Bleecker ER, Calhoun WJ, Castro M, Comhair SA, et al. Severe asthma: lessons learned from the National Heart, Lung, and Blood Institute Severe Asthma Research Program. Am J Respir Crit Care Med. 2012;185(4):356–62.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Walker C, Gupta S, Hartley R, Brightling CE. Computed tomography scans in severe asthma: utility and clinical implications. Curr Opin Pulm Med. 2012;18(1):42–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Brown MS, Kim HJ, Abtin F, Da Costa I, Pais R, Ahmad S, et al. Reproducibility of lung and lobar volume measurements using computed tomography. Acad Radiol. 2010;17(3):316–22.

    Article  PubMed  Google Scholar 

  28. Sorkness RL, Bleecker ER, Busse WW, Calhoun WJ, Castro M, Chung KF, et al. Lung function in adults with stable but severe asthma: air trapping and incomplete reversal of obstruction with bronchodilation. J Appl Physiol (1985). 2008;104(2):394–403.

    Article  Google Scholar 

  29. Gupta S, Siddiqui S, Haldar P, Raj JV, Entwisle JJ, Wardlaw AJ, et al. Qualitative analysis of high-resolution CT scans in severe asthma. Chest. 2009;136(6):1521–8.

    Article  PubMed  PubMed Central  Google Scholar 

  30. de Jong PA, Muller NL, Pare PD, Coxson HO. Computed tomographic imaging of the airways: relationship to structure and function. Eur Respir J. 2005;26(1):140–52.

    Article  PubMed  Google Scholar 

  31. Aysola RS, Hoffman EA, Gierada D, Wenzel S, Cook-Granroth J, Tarsi J, et al. Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology. Chest. 2008;134(6):1183–91.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Chiro GD, Brooks RA, Kessler RM, et al. Tissue signatures with dual-energy computed tomography. Radiology. 1979;131:521–3.

    Article  CAS  PubMed  Google Scholar 

  33. Chae EJ, Seo JB, Lee J, et al. Xenon ventilation imaging using dual-energy computed tomography in asthmatics: initial experience. Investig Radiol. 2010;45:354–61.

    Google Scholar 

  34. Kong X, Sheng HX, Lu GM, Meinel FG, Dyer KT, Schoepf UJ, et al. Xenon-enhanced dual-energy CT lung ventilation imaging: techniques and clinical applications. AJR Am J Roentgenol. 2014;202(2):309–17.

    Article  PubMed  Google Scholar 

  35. Jung JW, Kwon JW, Kim TW, Lee SH, Kim KM, Kang HR, et al. New insight into the assessment of asthma using xenon ventilation computed tomography. Ann Allergy Asthma Immunol. 2013;111(2):90–5.

    Article  PubMed  Google Scholar 

  36. Altes TA, Powers PL, Knight-Scott J, Rakes G, Platts-Mills TAE, de Lange EE, et al. Hyperpolarized 3He MR lung ventilation imaging in asthmatics: preliminary findings. J Magn Reson Imaging. 2001;13:378–84.

    Article  CAS  PubMed  Google Scholar 

  37. Hahn AD, Cadman RV, Sorkness RL, Jarjour NN, Nagle SK, Fain SB. Redistribution of inhaled hyperpolarized 3He gas during breath-hold differs by asthma severity. J Appl Physiol. 2016;120(5):526–36.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gong Yong Jin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter

Jin, G.Y. (2018). Radiologic Diagnostic Modalities in Severe Asthma. In: Lee, Y., Kim, S., Cho, S. (eds) Severe Asthma. Springer, Singapore. https://doi.org/10.1007/978-981-10-1998-2_5

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-1998-2_5

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-1997-5

  • Online ISBN: 978-981-10-1998-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics