Methacholine-induced temporal changes in airway geometry and lung density by CT.
OBJECTIVE
Electron-beam CT (EBCT) was utilized to assess the time course of changes in airways cross-sectional area (CSA) and lung density during methacholine-induced bronchoconstriction.


METHODS
EBCT scans (200 ms, 3-mm thickness, 2 mm increments) were obtained before (baseline) and 30 s, 2 min, and 4 min after bolus IV injection of methacholine to pigs receiving mechanical ventilation. A total of seven experiments were analyzed using custom-made image analysis software. With each challenge, five different airways and 50 lung regions of interest were studied.


RESULTS
The time course of lung density changes paralleled the time course for CSA changes. The maximal response to methacholine, measured in terms of both CSA and lung density changes, occurred 30 s after injection. Lung density changes were unaffected by reconstruction algorithm, normal (standard) or sharp (high resolution). Overall, there was increased air content in the lung during bronchoconstriction. This effect was significantly greater at the dependent lung regions.


CONCLUSIONS
EBCT is an effective tool to assess temporal and regional changes in the lung during bronchoconstriction. Measurements of lung density during bronchoconstriction allow for assessment of peripheral changes that are beyond the CT spatial resolution of airways anatomy.
Amirav
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Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. amirav@012.net.il
Kramer
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Grunstein
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MM
D000818:Animals; D016084:Bronchoconstriction; D016085:Bronchoconstrictor Agents / Q000494:pharmacology*; D008168:Lung / Q000000981:diagnostic imaging* / Q000187:drug effects*; D016210:Methacholine Chloride / Q000494:pharmacology*; D012121:Respiration, Artificial; D013552:Swine; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride