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CT Scans Safe and Effective in Detecting Remodeling in the Airways of Asthmatic Children

New research finds that high-resolution computer tomography (HRCT) scans may be a safe and effective way to detect undesired morphologic changes (“remodeling”) in the airways of children with severe asthma. These findings are featured in the October 2005 Journal of Allergy & Clinical Immunology (JACI). The JACI is the peer-reviewed, scientific journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Up until now, clear evaluation of airway inflammation and remodeling in children could only be measured by invasive techniques, such as a tissue biopsy of the airways performed during bronchoscopy.

Through the use of HRCT scans of the chest, researchers have previously found that children with severe asthma have significantly greater bronchial wall thickness than normal children. HRCT scans performed on adults were successful in showing the abnormalities of the airways, in particular the extent of bronchial wall thickening (BWT) and how it correlates with lung function and other markers of asthma severity.

Because previous techniques in children had been so invasive, researcher Jacques de Blie, MD, the Université René Descartes, Paris, and colleagues began investigating less invasive techniques. The researchers investigated 37 children with severe asthma to determine whether an HRCT scan was as effective in measuring inflammation and remodeling in the airways as other more established methods.

The study found HRCT scan results had similar results with those obtained through bronchial biopsy (measuring reticular basement membrane thickness) and also correlated well with other validated measurements of airway inflammation (such as those measured with exhaled NO).

This is the first study suggesting a relationship between radiological findings on chest CT scans and characteristics of remodeling. HRCT is a non-invasive tool that may be valuable for measuring airway remodeling in children with asthma and the new generations of multi-slice CT scanners will allow higher definition and lower radiation exposure, thus hopefully allowing a better assessment of airway remodeling and efficacy of treatment in asthmatic children.

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