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Eur Respir J 2004; 24:211-218
Copyright ©ERS Journals Ltd 2004

Heterogeneity of narrowing in normal and asthmatic airways measured by HRCT

G.G. King1,5,6, J.D. Carroll5,6, N.L. Müller2, K.P. Whittall3, M. Gao4, Y. Nakano1 and P.D. Paré1

1 University of British Columbia, James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research, St. Paul's Hospital, 2 Dept of Radiology and Thoracic Imaging Group, Vancouver Hospital, 3 Dept of Radiology, UBC Hospital, 4 Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, Vancouver, Canada. 5 Woolcock Institute of Medical Research, University of Sydney 2006, and 6 Cooperative Research Centre for Asthma, Sydney, Australia

CORRESPONDENCE: G.G. King, Woolcock Institute of Medical Research, University of Sydney 2006, Sydney, Australia. Fax: 61 299066391. E-mail: ggk@woolcock.org.au

Keywords: Airway narrowing, asthma, heterogeneity, quantitative high resolution computed tomography

Received: April 30, 2003
Accepted April 16, 2004

This work was supported, in part, by an operating grant from the Canadian Institutes of Health Research. G.G. King was supported by a MRC/CLA postdoctoral fellowship #9611J9N-1003-46453, an Astra/MRC/PMAC Canada Fellowship and AstraZeneca ALF grant-in-Aid.

Asthmatic airway narrowing is heterogeneous and contributes to airway hyperresponsiveness. The present study compared heterogeneity of narrowing during methacholine challenge in asthmatics and normal subjects using high-resolution computed tomography (HRCT).

The current authors defined heterogeneity as variability in narrowing greater than the repeatability of measurement. Airways of <2 mm diameter were compared with larger airways from baseline and postmethacholine HRCT of the right lower lung in 13 normals (seven had repeat baseline scans) and seven asthmatics. The coefficient of repeatability was calculated from repeat scans (RepAi) and was compared with heterogeneity of narrowing measured by the variability in narrowing from pre versus postmethacholine scans (Var{Delta}Ai).

Forced expiratory volume in one second decreased 27±6% and 24±8% in normals and asthmatics, respectively. Airways >2 mm narrowed more heterogeneously in asthmatics (Var{Delta}Ai=±0.85 mm) compared with normals (Var{Delta}Ai=±0.67 mm), with both being greater than the measure of repeatability (RepAi=±0.16 mm). Small airway narrowing was not heterogeneous in asthmatics (Var{Delta}Ai=±0.59 mm) or normals (Var{Delta}Ai=±0.53 mm) compared with repeatability (RepAi=0.51 mm).

It is possible to study heterogeneity of airway narrowing in small and large airways using high resolution computed tomography. Airway narrowing is heterogeneous in the large airways of asthmatics and normals, being greater in asthmatics.




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