The Association Between Bronchial Wall CT Attenuation and Spirometry in Patients with Bronchial Asthma

Shoichiro Matsushita; Tsuneo Yamashiro; Shin Matsuoka; Kunihiro Yagihashi; Yasuo Nakajima

doi:10.1016/j.acra.2018.09.023

The Association Between Bronchial Wall CT Attenuation and Spirometry in Patients with Bronchial Asthma

Acad Radiol. 2019 Jul;26(7):960-966. doi: 10.1016/j.acra.2018.09.023. Epub 2018 Oct 28.

Authors

Shoichiro Matsushita¹, Tsuneo Yamashiro², Shin Matsuoka³, Kunihiro Yagihashi³, Yasuo Nakajima³

Affiliations

¹ Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511, Japan. Electronic address: masho160@marianna-u.ac.jp.
² Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511, Japan; Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara, Okinawa, Japan.
³ Department of Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa 216-8511, Japan.

PMID: 30377058
DOI: 10.1016/j.acra.2018.09.023

Abstract

Rationale and objective: The purpose of this study was to evaluate the correlation between generation-based bronchial wall attenuation on thin-section computed tomography (CT) scans and airflow limitation in patients with bronchial asthma.

Materials and methods: This study included 28 bronchial asthma patients (13 men, 15 women; age range, 23-89 years) who underwent both chest CT and spirometry. On CT, the mean values of peak wall attenuation, wall area percentage, and luminal area were measured in the segmental, subsegmental, and sub-subsegmental bronchi of the right B1 and B10 bronchi. Correlations of the CT measurements with forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), percent predicted forced expiratory flow at 25%-75% of the FVC (%pred forced expiratory flow25-75), and percent predicted peak flow rate were evaluated with Spearman's rank correlation test.

Results: The peak wall attenuation of each generation of segmental bronchi significantly correlated with the forced expiratory volume in 1 second/FVC (B1 segmental, ρ = -0.683, p < 0.0001; B1 subsegmental, ρ = -0.875, p < 0.0001; B1 sub-subsegmental, ρ = -0.926, p < 0.0001; B10 segmental, ρ = -0.811, p < 0.0001; B10 subsegmental, ρ = -0.903, p < 0.0001; B10 sub-subsegmental ρ = -0.950, p < 0.0001). Similar correlations were found between the peak wall attenuation and %pred forced expiratory flow 25-75 or percent predicted peak flow rate. Overall, the correlation coefficients were relatively high in the more peripheral bronchial generations. In all measurements, the coefficients of the peak wall attenuations were higher than those of the wall area percentage and luminal area.

Conclusion: Peak attenuation of the bronchial wall, particularly in the peripheral bronchi, measured on CT is a good biomarker for the severity of bronchial asthma.

Keywords: Airflow limitation; Bronchial asthma; Bronchial wall CT attenuation; Computed tomography; Spirometry.

MeSH terms

Adult
Aged
Aged, 80 and over
Asthma / diagnostic imaging*
Asthma / physiopathology*
Bronchi / diagnostic imaging*
Female
Forced Expiratory Volume
Humans
Male
Middle Aged
Peak Expiratory Flow Rate
Severity of Illness Index
Spirometry
Tomography, X-Ray Computed*
Vital Capacity
Young Adult