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. 2001 Nov;56(11):851–856. doi: 10.1136/thorax.56.11.851

Influence of age and disease severity on high resolution CT lung densitometry in asthma

F Mitsunobu 1, T Mifune 1, K Ashida 1, Y Hosaki 1, H Tsugeno 1, M Okamoto 1, S Harada 1, S Takata 1, Y Tanizaki 1
PMCID: PMC1745946  PMID: 11641509

Abstract

BACKGROUND—Low attenuation areas (LAA) on computed tomographic (CT) scans have been shown to represent emphysematous changes in patients with chronic obstructive pulmonary disease (COPD). However, the significance of LAA is still controversial in patients with asthma. This study was undertaken to assess the usefulness of lung CT densitometry in the detection of airspace enlargement in association with asthma severity.
METHODS—Forty five asthmatic subjects and 15 non-smoking controls were studied to determine the influence of age, pulmonary function, and asthma severity on mean lung density (MLD) and the relative area of the lung showing attenuation values less than -950 HU (RA950) on high resolution CT (HRCT) scans.
RESULTS—In asthmatic patients both MLD and RA950 correlated with parameters of airflow limitation (%FEV1, FEV1/FVC, %FEF25-75) and lung volume (%TLC, %FRC, %RV), but not with lung transfer factor (%TLCO, %TLCO/VA). The results of HRCT lung densitometry also correlated with patient age and severity of asthma.
CONCLUSIONS—Decreased CT lung density in non-smoking asthmatics is related to airflow limitation, hyperinflation and aging, but not with lung transfer factor.



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Selected References

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  1. Bae K. T., Slone R. M., Gierada D. S., Yusen R. D., Cooper J. D. Patients with emphysema: quantitative CT analysis before and after lung volume reduction surgery. Work in progress. Radiology. 1997 Jun;203(3):705–714. doi: 10.1148/radiology.203.3.9169692. [DOI] [PubMed] [Google Scholar]
  2. Bergin C., Müller N., Nichols D. M., Lillington G., Hogg J. C., Mullen B., Grymaloski M. R., Osborne S., Paré P. D. The diagnosis of emphysema. A computed tomographic-pathologic correlation. Am Rev Respir Dis. 1986 Apr;133(4):541–546. doi: 10.1164/arrd.1986.133.4.541. [DOI] [PubMed] [Google Scholar]
  3. Biernacki W., Redpath A. T., Best J. J., MacNee W. Measurement of CT lung density in patients with chronic asthma. Eur Respir J. 1997 Nov;10(11):2455–2459. doi: 10.1183/09031936.97.10112455. [DOI] [PubMed] [Google Scholar]
  4. Bousquet J., Chanez P., Lacoste J. Y., White R., Vic P., Godard P., Michel F. B. Asthma: a disease remodeling the airways. Allergy. 1992 Feb;47(1):3–11. doi: 10.1111/j.1398-9995.1992.tb02242.x. [DOI] [PubMed] [Google Scholar]
  5. Carroll N., Elliot J., Morton A., James A. The structure of large and small airways in nonfatal and fatal asthma. Am Rev Respir Dis. 1993 Feb;147(2):405–410. doi: 10.1164/ajrccm/147.2.405. [DOI] [PubMed] [Google Scholar]
  6. Coxson H. O., Rogers R. M., Whittall K. P., D'yachkova Y., Paré P. D., Sciurba F. C., Hogg J. C. A quantification of the lung surface area in emphysema using computed tomography. Am J Respir Crit Care Med. 1999 Mar;159(3):851–856. doi: 10.1164/ajrccm.159.3.9805067. [DOI] [PubMed] [Google Scholar]
  7. Djukanović R., Roche W. R., Wilson J. W., Beasley C. R., Twentyman O. P., Howarth R. H., Holgate S. T. Mucosal inflammation in asthma. Am Rev Respir Dis. 1990 Aug;142(2):434–457. doi: 10.1164/ajrccm/142.2.434. [DOI] [PubMed] [Google Scholar]
  8. Ebina M., Takahashi T., Chiba T., Motomiya M. Cellular hypertrophy and hyperplasia of airway smooth muscles underlying bronchial asthma. A 3-D morphometric study. Am Rev Respir Dis. 1993 Sep;148(3):720–726. doi: 10.1164/ajrccm/148.3.720. [DOI] [PubMed] [Google Scholar]
  9. Eda S., Kubo K., Fujimoto K., Matsuzawa Y., Sekiguchi M., Sakai F. The relations between expiratory chest CT using helical CT and pulmonary function tests in emphysema. Am J Respir Crit Care Med. 1997 Apr;155(4):1290–1294. doi: 10.1164/ajrccm.155.4.9105069. [DOI] [PubMed] [Google Scholar]
  10. Fletcher C. M., Pride N. B. Definitions of emphysema, chronic bronchitis, asthma, and airflow obstruction: 25 years on from the Ciba symposium. Thorax. 1984 Feb;39(2):81–85. doi: 10.1136/thx.39.2.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Gevenois P. A., De Vuyst P., Sy M., Scillia P., Chaminade L., de Maertelaer V., Zanen J., Yernault J. C. Pulmonary emphysema: quantitative CT during expiration. Radiology. 1996 Jun;199(3):825–829. doi: 10.1148/radiology.199.3.8638012. [DOI] [PubMed] [Google Scholar]
  12. Gevenois P. A., De Vuyst P., de Maertelaer V., Zanen J., Jacobovitz D., Cosio M. G., Yernault J. C. Comparison of computed density and microscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1996 Jul;154(1):187–192. doi: 10.1164/ajrccm.154.1.8680679. [DOI] [PubMed] [Google Scholar]
  13. Gevenois P. A., Scillia P., de Maertelaer V., Michils A., De Vuyst P., Yernault J. C. The effects of age, sex, lung size, and hyperinflation on CT lung densitometry. AJR Am J Roentgenol. 1996 Nov;167(5):1169–1173. doi: 10.2214/ajr.167.5.8911175. [DOI] [PubMed] [Google Scholar]
  14. Gevenois P. A., de Maertelaer V., De Vuyst P., Zanen J., Yernault J. C. Comparison of computed density and macroscopic morphometry in pulmonary emphysema. Am J Respir Crit Care Med. 1995 Aug;152(2):653–657. doi: 10.1164/ajrccm.152.2.7633722. [DOI] [PubMed] [Google Scholar]
  15. Gould G. A., MacNee W., McLean A., Warren P. M., Redpath A., Best J. J., Lamb D., Flenley D. C. CT measurements of lung density in life can quantitate distal airspace enlargement--an essential defining feature of human emphysema. Am Rev Respir Dis. 1988 Feb;137(2):380–392. doi: 10.1164/ajrccm/137.2.380. [DOI] [PubMed] [Google Scholar]
  16. Gould G. A., Redpath A. T., Ryan M., Warren P. M., Best J. J., Cameron E. J., MacNee W. Parenchymal emphysema measured by CT lung density correlates with lung function in patients with bullous disease. Eur Respir J. 1993 May;6(5):698–704. doi: 10.1016/s0012-3692(16)47462-3. [DOI] [PubMed] [Google Scholar]
  17. Gould G. A., Redpath A. T., Ryan M., Warren P. M., Best J. J., Flenley D. C., MacNee W. Lung CT density correlates with measurements of airflow limitation and the diffusing capacity. Eur Respir J. 1991 Feb;4(2):141–146. [PubMed] [Google Scholar]
  18. Heremans A., Verschakelen J. A., Van fraeyenhoven L., Demedts M. Measurement of lung density by means of quantitative CT scanning. A study of correlations with pulmonary function tests. Chest. 1992 Sep;102(3):805–811. doi: 10.1378/chest.102.3.805. [DOI] [PubMed] [Google Scholar]
  19. Kinsella M., Müller N. L., Abboud R. T., Morrison N. J., DyBuncio A. Quantitation of emphysema by computed tomography using a "density mask" program and correlation with pulmonary function tests. Chest. 1990 Feb;97(2):315–321. doi: 10.1378/chest.97.2.315. [DOI] [PubMed] [Google Scholar]
  20. Kuwano K., Matsuba K., Ikeda T., Murakami J., Araki A., Nishitani H., Ishida T., Yasumoto K., Shigematsu N. The diagnosis of mild emphysema. Correlation of computed tomography and pathology scores. Am Rev Respir Dis. 1990 Jan;141(1):169–178. doi: 10.1164/ajrccm/141.1.169. [DOI] [PubMed] [Google Scholar]
  21. Miniati M., Filippi E., Falaschi F., Carrozzi L., Milne E. N., Sostman H. D., Pistolesi M. Radiologic evaluation of emphysema in patients with chronic obstructive pulmonary disease. Chest radiography versus high resolution computed tomography. Am J Respir Crit Care Med. 1995 May;151(5):1359–1367. doi: 10.1164/ajrccm.151.5.7735585. [DOI] [PubMed] [Google Scholar]
  22. Mishima M., Hirai T., Itoh H., Nakano Y., Sakai H., Muro S., Nishimura K., Oku Y., Chin K., Ohi M. Complexity of terminal airspace geometry assessed by lung computed tomography in normal subjects and patients with chronic obstructive pulmonary disease. Proc Natl Acad Sci U S A. 1999 Aug 3;96(16):8829–8834. doi: 10.1073/pnas.96.16.8829. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Mishima M., Itoh H., Sakai H., Nakano Y., Muro S., Hirai T., Takubo Y., Chin K., Ohi M., Nishimura K. Optimized scanning conditions of high resolution CT in the follow-up of pulmonary emphysema. J Comput Assist Tomogr. 1999 May-Jun;23(3):380–384. doi: 10.1097/00004728-199905000-00011. [DOI] [PubMed] [Google Scholar]
  24. Mitsunobu F., Mifune T., Ashida K., Hosaki Y., Tsugeno H., Okamoto M., Harada S., Tanizaki Y. Low-attenuation areas of the lungs on high-resolution computed tomography in asthma. J Asthma. 2001 Aug;38(5):413–422. doi: 10.1081/jas-100001496. [DOI] [PubMed] [Google Scholar]
  25. Müller N. L., Staples C. A., Miller R. R., Abboud R. T. "Density mask". An objective method to quantitate emphysema using computed tomography. Chest. 1988 Oct;94(4):782–787. doi: 10.1378/chest.94.4.782. [DOI] [PubMed] [Google Scholar]
  26. Nakano Y., Sakai H., Muro S., Hirai T., Oku Y., Nishimura K., Mishima M. Comparison of low attenuation areas on computed tomographic scans between inner and outer segments of the lung in patients with chronic obstructive pulmonary disease: incidence and contribution to lung function. Thorax. 1999 May;54(5):384–389. doi: 10.1136/thx.54.5.384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Newman K. B., Lynch D. A., Newman L. S., Ellegood D., Newell J. D., Jr Quantitative computed tomography detects air trapping due to asthma. Chest. 1994 Jul;106(1):105–109. doi: 10.1378/chest.106.1.105. [DOI] [PubMed] [Google Scholar]
  28. Paganin F., Séneterre E., Chanez P., Daurés J. P., Bruel J. M., Michel F. B., Bousquet J. Computed tomography of the lungs in asthma: influence of disease severity and etiology. Am J Respir Crit Care Med. 1996 Jan;153(1):110–114. doi: 10.1164/ajrccm.153.1.8542102. [DOI] [PubMed] [Google Scholar]
  29. Petty T. L., Silvers G. W., Stanford R. E. Functional correlations with mild and moderate emphysema in excised human lungs. Am Rev Respir Dis. 1981 Dec;124(6):700–704. doi: 10.1164/arrd.1981.124.6.700. [DOI] [PubMed] [Google Scholar]
  30. Rosenberg M., Patterson R., Mintzer R., Cooper B. J., Roberts M., Harris K. E. Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillosis. Ann Intern Med. 1977 Apr;86(4):405–414. doi: 10.7326/0003-4819-86-4-405. [DOI] [PubMed] [Google Scholar]
  31. Sakai N., Mishima M., Nishimura K., Itoh H., Kuno K. An automated method to assess the distribution of low attenuation areas on chest CT scans in chronic pulmonary emphysema patients. Chest. 1994 Nov;106(5):1319–1325. doi: 10.1378/chest.106.5.1319. [DOI] [PubMed] [Google Scholar]
  32. Soejima K., Yamaguchi K., Kohda E., Takeshita K., Ito Y., Mastubara H., Oguma T., Inoue T., Okubo Y., Amakawa K. Longitudinal follow-up study of smoking-induced lung density changes by high-resolution computed tomography. Am J Respir Crit Care Med. 2000 Apr;161(4 Pt 1):1264–1273. doi: 10.1164/ajrccm.161.4.9905040. [DOI] [PubMed] [Google Scholar]

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