High-resolution CT Features of Severe Asthma and Bronchiolitis Obliterans

AIM: To evaluate the high-resolution CT findings of severe asthma (SA) and bronchiolitis obliterans (BO) and determine whether any reliable discriminating HRCT features exist. MATERIALS AND METHODS: HRCT examinations of the chest of 30 patients with SA and 14 patients with BO were analysed. Images w...

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Bibliographic Details
Published in:Clinical radiology 2002-12, Vol.57 (12), p.1078-1085
Main Authors: Jensen, S.P, Lynch, D.A, Brown, K.K, Wenzel, S.E, Newell, J.D
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Asthma - diagnostic imaging
asthma, computed tomography (CT), thin section, bronchiolitis obliterans, lung diseases, CT
Bronchiolitis Obliterans - diagnostic imaging
Child
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Tomography, X-Ray Computed - methods
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Summary:AIM: To evaluate the high-resolution CT findings of severe asthma (SA) and bronchiolitis obliterans (BO) and determine whether any reliable discriminating HRCT features exist. MATERIALS AND METHODS: HRCT examinations of the chest of 30 patients with SA and 14 patients with BO were analysed. Images were scored for the presence and extent of 21 CT findings. RESULTS: The most consistent HRCT features in SA were bronchial wall thickening in 30 (100%), expiratory air trapping in 19 of 22 examinations with expiratory images (87%), inspiratory decreased attenuation in 18 (60%), and bronchial luminal narrowing in 12 (40%). The most consistent HRCT features in BO were expiratory air trapping in 10 of 10 examinations with expiratory images (100%), bronchial wall thickening in 13 (93%), inspiratory decreased attenuation in 11 (79%), ground glass opacity in seven (50%), and mosaic pattern of attenuation in seven (50%). Decreased attenuation was more extensive in BO than in SA on both inspiratory and expiratory images. The mosaic pattern of attenuation was present in seven (50%) BO patients but in only one (3%) SA patients (P=0.0006). CONCLUSIONS: Mosaic pattern of attenuation, when present, is highly suggestive of BO, but SA and BO may be indistinguishable. Jensen, S. P. et al. (2002). Clinical Radiology57, 1078–1085.
ISSN:0009-9260
1365-229X
DOI:10.1053/crad.2002.1104