Enter Your Email Address to Receive a
Copy of MedicExhange Member Demograhpics

In most patients with severe asthma, high-resolution computed tomography (HRCT) reveals airway wall thickening and other changes not otherwise detectable, UK researchers report in the December issue of Chest.

"Our report is the largest qualitative study of HRCT findings in severe asthma," senior investigator Dr. Christopher E. Brightling told Reuters Health. "We found that abnormalities in the airway wall were common and could not be identified by the physician without the CT scans."

Dr. Brightling, of the University of Leicester, and his colleagues reviewed data on 463 patients with difficult asthma, 185 of whom had HRCT scans for clinical indications.

The scans showed bronchial wall thickening in 62%, bronchiectasis in 40% and emphysema in 8%. These conditions often co-existed, and HRCT scans were normal in only 20% of cases.

The most common indication for HRCT was a clinical suspicion of bronchiectasis. Clinical evaluation had only a 74% sensitivity and a 45% specificity for identifying bronchiectasis in patients who had HRCT scans that revealed it.

An FEV1/FVC ratio of 75% or more was an important predictor of bronchial wall thickening and bronchiectasis, but had low discriminatory power in those without airway structural changes (sensitivity, 67%; specificity, 65%).

"The identification of these abnormalities," concluded Dr. Brightling, "potentially affects the way we treat a person's asthma and therefore underscores the importance of CT scans in severe asthma."

Source: Reuters Health

Discuss more about CT in our CT Group