Bronchial measurements in patients with asthma: comparison of quantitative thin-section CT findings with those in healthy subjects and correlation with pathologic findings.
OBJECTIVE
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.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
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. michel.montaudon@chu-bordeaux.fr
Michel
M
Montaudon
Mathieu
M
Lederlin
Stéphanie
S
Reich
Hugues
H
Begueret
José Manuel
JM
Tunon-de-Lara
Roger
R
Marthan
Patrick
P
Berger
François
F
Laurent
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001249:Asthma / Q000000981:diagnostic imaging* / Q000473:pathology; D001706:Biopsy; D001980:Bronchi / Q000473:pathology*; D001995:Bronchography / Q000379:methods*; D001999:Bronchoscopy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*