Skip to main content
Log in

Abnormalities of the airways and lung parenchyma in asthmatics: CT observations in 50 patients and inter- and intraobserver variability

  • Chest Radiology
  • Original article
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of the study was to evaluate the CT abnormalities of airways and lung parenchyma in asthmatic patients and to assess inter- and intraobserver variability for these abnormalities. The CT scans of 50 asthmatic patients and 10 healthy volunteers were assessed independently by four independent chest radiologist who were masked with respect to the clinical information. Bronchiectasis involving mostly subsegmental and distal bronchi was noted in 28.5% of the asthmatic subjects and none of the non-asthmatics. Bronchial wall thickening, small centrilobular opacities and decreased lung attenuation were observed in 82%, 21% and 31% of asthmatic patients respectively, compared with 7%, 5% and 7% of healthy subjects. The intra- and inter-observer agreements for these four CT abnormalities were measured by the kappa statistic and ranged from 0.60 to 0.79 and from 0.40 to 0.60, respectively. It os concluded that asthmatic patients may exhibit bronchial wall thickening, bronchiectasis and morphological abnormalities suggestive of distal airways disease that can be assessed on CT scans with a clinically acceptable observer variability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Paganin F, Trussard V, Seneterre E, Chanez P, Giron J, Godard P, Sénac JP, Michel FB, Bousquet J (1992) Chest radiography and high resolution computed tomography of the lungs in asthma. Am Rev Respir Dis 146: 1084–1087

    Google Scholar 

  2. Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) Uncomplicated asthma in adults: comparison of CT apperance of the lungs in asthmatic and healthy subjects. Radiology 188: 829–833

    Google Scholar 

  3. Meneely GR, Renzetti AD, Steele JD, Wyatt JP, Harris HW (1962) American Thoracic Society: chronic bronchitis, asthma, and pulmonary emphysema. Am Rev Respir Dis 85: 762–768

    Google Scholar 

  4. Rosenberg M, Patterson R, Mintzer R, Cooper BJ, Roberts M, Harris KE (1977) Clinical and immunologic criteria for the diagnosis of allergic bronchopulmonary aspergillois. Ann Intern Med 86: 405–414

    Google Scholar 

  5. Aas K (1981) Heterogeneity of bronchial asthma: sub-populations or different stages of the disease. Allergy 36: 3–14

    Google Scholar 

  6. Naidich DP, McCauley DI, Khouri NF, Stitik FP, Siegelman SS (1982) Computed tomography of bronchiectasis. J Comput Assist Tomogr 6: 437–444

    Google Scholar 

  7. Gruden JF, Webb WR, Warnock M (1994) Centrilobular opacities in the lung on high resolution CT: diagnostic considerations and pathologic correlation. AJR 162: 569–574

    Google Scholar 

  8. Fleiss JL (1971) Measuring nominal scale agreement among many raters. Psychol Bull 76: 378–382

    Google Scholar 

  9. Siegel S, Castellan NJ (1988) Nonparametric statistics for the behavioral sciences, 2nd edn. McGraw-Hill, New York

    Google Scholar 

  10. Neeld DA, Goodman LR, Gurney JW, Greenberger PA, Fink JV (1990) Computerized tomography in the evaluation of allergic bronchopulmonary aspergillosis. Am Rev Respir Dis 142: 1200–1205

    Google Scholar 

  11. Rémy-Jardin M, Rémy J, Boulenguez C, Sobaszek A, Edme JL, Furon D (1993) Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests. Radiology 186: 107–115

    CAS  PubMed  Google Scholar 

  12. Bhalla M, Turcios N, Aponte V, Jenkins M, Leitman BS, McCauley DI, Naidich DP (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179: 783–788

    Google Scholar 

  13. Grenier P, Maurice F, Musset D, Menu Y, Nahum H (1986) Bronchiectasis: assessment with thin-section CT. Radiology 161: 95–99

    Google Scholar 

  14. Padley SPG, Adler BD, Hansell DM, Müller NL (1993) Bronchiolitis obliterans: high resolution CT findings and correlation with pulmonary function tests. Clin Radiol 47: 236–240

    Google Scholar 

  15. Hansell DM, Strickland B (1989) High-resolution computed tomography in pulmonary cystic fibrosis. Br J Radiol 62: 1–15

    Google Scholar 

  16. Akira M, Kitatani F, Yong-Sik L, Kita N, Yamamoto S, Higashihara T, Morimoto S, Ikezoe J, Kozuka T (1988) Diffuse panbronchiolitis: evaluation with high-resolution CT. Radiology 163: 433–438

    Google Scholar 

  17. Morrish WF, Herman SJ, Weisbrod GL, Chamberlain DW (1991) Bronchiolitis obliterans after lung transplantation: findings at chest radiography and high-resolution CT. Radiology 179: 487–490

    Google Scholar 

  18. Lentz D, Bergin CJ, Berry CJ, Stoehr C, Theodore J (1992) Diagnosis of bronchiolitis obliterans in heart-lung transplantation patients: importance of bronchial dilatation on CT. AJR 159: 463–467

    Google Scholar 

  19. Wong-You-Cheong JJ, Leahy BC, Taylor PM, Church SE (1992) Airways obstruction and bronchiectasis: correlation with duration of symptoms and extent of bronchiectasis on computed tomography. Clin Radiol 45: 256–259

    Google Scholar 

  20. Hansell DM, Wells AU, Rubens MB, Cole PJ (1994) Bronchiectasis: functional: significance of areas of decreased attenuation at expiratory CT. Radiology 193: 369–374

    Google Scholar 

  21. Coblentz CL, Babcook CJ, Alton D, Riley BJ, Norman G (1991) Observer variation in detecting the radiologic features associated with bronchiolitis. Invest Radiol 26: 115–118

    Google Scholar 

  22. Herold CJ, Wetzel RC, Robotham JL, Herold SM, Zerhouni EA (1992) Acute effects of increased intravascular volume and hypoxia on the pulmonary circulation: assessment with high-resolution CT. Radiology 183: 655–662

    Google Scholar 

  23. Wetzel RC, Herold CJ, Zerhouni EA, Robotham JL (1992) Hypoxic bronchodilation. J Appl Physiol 73: 1202–1206

    Google Scholar 

  24. Grenier P, Cordeau MP, Beigelman C (1993) High-resolution computed tomography of the airways. J Thorac Imaging 8: 213–229

    Google Scholar 

  25. Naidich DP, Webb WR, Müller NL (1993) Thracic computed tomography: current concepts. In: Potchen EJ, Grainger RG, Greene R (eds) Pulmonary radiology. Fleischner Society/Saunders, Philadelphia, pp 386–404

    Google Scholar 

  26. Remy-Jardin M, Remy J (1988) Comparison of vertical and oblique CT in evaluation of bronchial tree. J Comput Assist Tomogr 12: 956–962

    Google Scholar 

  27. Dunnil M (1960) The pathology of asthma, with special reference to changes in the bronchial mucosa. J Clin Pathol 13: 27–33

    Google Scholar 

  28. Caroll N, Elliot J, Morton A, James A (1993) The structure of large and small airways in nonfatal and fatal. Am Rev Respir Dis 147: 405–410

    Google Scholar 

  29. Eisen AH, Bacal HL (1963) The relationship of acute bronchiolitis to bronchial asthma: a4- to 14-year follow-up. Pediatrics 31: 859–861

    Google Scholar 

  30. Gurwitz D, Mindorff C, Levison H (1981) Increased incidence of bronchial reactivity in children with a history of bronchiolitis. J Pediatr 98: 551–555

    Google Scholar 

  31. Pullan CR, Hey EN (1982) Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy. BMJ 284: 1665–1669

    Google Scholar 

  32. Webb WR, Gamsu G, Wall SD, Cann CE, Proctor E (1984) CT of a bronchial phantom: factors affecting appearance and size measurement. Invest Radiol 19: 394–398

    Google Scholar 

  33. Stern EJ, Frank MS (1994) Small-airway diseases of the lungs: findings at expiratory CT. AJR 163: 37–41

    Google Scholar 

  34. Kondoh Y, Taniguchi H, Yokoyama S, Taki S, Takagi K, Satake T (1990) Emphysematous change in chronic asthma in relation to cigarette smoking: assessment by computed tomography. Chest 97: 845–849

    Google Scholar 

  35. Remy-Jardin M, Remy J, Gosselin B, Becette V, Edure JC (1993) Lung parenchymal changes secondary to cigarette smoking: pathologic-CT correlations. Radiology 186: 643–651

    Google Scholar 

  36. Soboya RE (1984) Quantitative structural alterations in long-standing allergic asthma. Am Rev Respir Dis 130: 289–292

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Correspondence to: P. Grenier

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grenier, P., Mourey-Gerosa, I., Benali, K. et al. Abnormalities of the airways and lung parenchyma in asthmatics: CT observations in 50 patients and inter- and intraobserver variability. Eur. Radiol. 6, 199–206 (1996). https://doi.org/10.1007/BF00181147

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00181147

Key words

Navigation