|Grzegorz Mincewicz, Agnieszka Aloszko, Eliza Wasilewska, Wojciech Kurowski, Ewa Mierzejewska|
Introduction. Asthma, which is characterised by airway remodelling manifested by thicker walls of large and small bronchi in severe asthma, and of small bronchi in mild asthma, is often preceded by perennial allergic rhinitis (PAR).
Aim of the study. To assess the impaired patency of bronchioles we analysed the difference between lung tissue density (LTD) on inspiratory and expiratory high resolution computed tomography (HRCT) scans and the frequency of "air trapping" episodes.
Material and methods. 30 patients with asthma, 48 with PAR and 20 healthy subjects (control group - CG) were enrolled to the study. HRCT was performed at inspiration and expiration. LTD in Hounsfield units (HU) was measured at three levels of the lung - the upper (U), middle (M) and lower field (L).
Results. The mean differences between the inspiratory and expiratory LTD in U/M/L fields were: 88/80/77 HU in asthmatics, 107/105/113 HU in PAR patients, and 134/115/143 HU in CG, respectively. In the asthmatics, the mean difference in LTD between inspiration and expiration was smaller than in CG in all examined fields and smaller than in PAR in the lower field. "Air trapping" was found in U/M/L field in 54/71/70 % of asthmatics, 48/54/42 % of patients with PAR and 25/35/10 % of CG, respectively. In the asthmatics, "air trapping" was significantly more frequent than in CG in all examined fields and more frequent than in PAR in the lower field. "Air trapping" frequency was significantly higher in PAR than in CG in the lower field.
Conclusions: In the asthmatic and in PAR patients, "air trapping" was observed more frequently than in healthy subjects. "Air trapping" on HRCT scans may represent an early sign of airway remodelling.
keywords: tomografia komputerowa wysokiej rozdzielczości (TKWR), przewlekły alergiczny nieżyt nosa (PANN), astma oskrzelowa (astma), pułapka powietrza, przebudowa dróg oddechowych (remodeling), high resolution computed tomography (HRCT), perennial allergic rhinitis
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