Computed Tomography in Severe Bronchial Asthma
Hassan El Sayed El Hodeiby;
Abstract
Recent advances in CT technology have revolutionized the non-invasive assessment of the airway. Multiplanar and 3D reconstruction images provide an important complementary method of viewing central airways disorders and offer the potential to improve diagnostic confidence and accuracy and enhance communication and planning for procedures.
These great advances in the imaging techniques of asthma allowed us to understand the pathophysiology and to localize the airway changes, which is not possible with pulmonary function tests which assess the global function of both lungs. We expect the future advances in CT technology, data-processing, and image display to further expand the role of multiplanar and 3D reconstruction images in the assessment of airway changes in bronchial asthma.
The diagnosis of asthma is mainly a clinical one with typical history of wheezes, cough and dyspnea on exposure to certain allergens. The cornerstone of the diagnosis is the reversibility of symptoms with bronchodilators. Moreover, the diagnosis is aided by the allergy testing and imaging. Further investigations are required according to the suspected alternative diagnosis; these investigations include ECG and echocardiography.
Not every asthmatic patient is going to have HRCT study. The main reason for referral of asthmatic patient to the radiology department is difficult-to-treat asthma or atypical clinical history warranting further assessment of the patient. The radiologist should be aware of what he is searching for during the interpretation of the findings, which in return requires knowledge of the normal radiological anatomy of the airways and the pathological changes affecting them in case of asthma.
Although HRCT is more costly than chest radiography and exposes the patient to more radiation, however, CT scans can demonstrate a number of findings that support the diagnosis of asthma. HRCT remains the most sensitive radiological study for morphologic changes associated with asthma. The HRCT plays a significant role in difficult to treat asthma by confirming the diagnosis of asthma, detection of complications or suggestion of an alternative diagnosis.
There are many of the HRCT findings that confirm the diagnosis of asthma including: bronchial wall thickening, bronchial dilatation, mucoid impaction, air trapping, and airway remodeling and decreased lung attenuation. All these findings can be evaluated adequately by HRCT.
Also, the radiologist should know the radiological features of the differential diagnosis of many other conditions that may mimic asthma clinically such as hypersensitivity pneumonitis and congestive heart failure, which will greatly aid in the diagnosis of bronchial asthma and exclusion of these conditions.
These great advances in the imaging techniques of asthma allowed us to understand the pathophysiology and to localize the airway changes, which is not possible with pulmonary function tests which assess the global function of both lungs. We expect the future advances in CT technology, data-processing, and image display to further expand the role of multiplanar and 3D reconstruction images in the assessment of airway changes in bronchial asthma.
The diagnosis of asthma is mainly a clinical one with typical history of wheezes, cough and dyspnea on exposure to certain allergens. The cornerstone of the diagnosis is the reversibility of symptoms with bronchodilators. Moreover, the diagnosis is aided by the allergy testing and imaging. Further investigations are required according to the suspected alternative diagnosis; these investigations include ECG and echocardiography.
Not every asthmatic patient is going to have HRCT study. The main reason for referral of asthmatic patient to the radiology department is difficult-to-treat asthma or atypical clinical history warranting further assessment of the patient. The radiologist should be aware of what he is searching for during the interpretation of the findings, which in return requires knowledge of the normal radiological anatomy of the airways and the pathological changes affecting them in case of asthma.
Although HRCT is more costly than chest radiography and exposes the patient to more radiation, however, CT scans can demonstrate a number of findings that support the diagnosis of asthma. HRCT remains the most sensitive radiological study for morphologic changes associated with asthma. The HRCT plays a significant role in difficult to treat asthma by confirming the diagnosis of asthma, detection of complications or suggestion of an alternative diagnosis.
There are many of the HRCT findings that confirm the diagnosis of asthma including: bronchial wall thickening, bronchial dilatation, mucoid impaction, air trapping, and airway remodeling and decreased lung attenuation. All these findings can be evaluated adequately by HRCT.
Also, the radiologist should know the radiological features of the differential diagnosis of many other conditions that may mimic asthma clinically such as hypersensitivity pneumonitis and congestive heart failure, which will greatly aid in the diagnosis of bronchial asthma and exclusion of these conditions.
Other data
| Title | Computed Tomography in Severe Bronchial Asthma | Other Titles | دور الأشعة المقطعية فى الربو الشعبى الحاد | Authors | Hassan El Sayed El Hodeiby | Issue Date | 2016 |
Attached Files
| File | Size | Format | |
|---|---|---|---|
| G13660.pdf | 524.23 kB | Adobe PDF | View/Open |
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