Lam, VSC

Ooi, CGC

Tsang, KWT

Hong Kong Medical Journal

HKU Scholars Hub

Title Functional significance of CT quantified bronchial wallthickening in bronchbiectasisAuthor(s) Lam, VSC; Tsang, KWT; Ooi, CGCCitationThe 8th Medical Research Conference Abstracts, Hong KongMedical Journal, Hong Kong, China, 25-26 January 2003, v. 9 n. 1Supp 1, p. 90Issued Date 2003URL http://hdl.handle.net/10722/45758Rights Creative Commons: Attribution 3.0 Hong Kong License90      HKMJ Vol 9 No 1 February 2003 SupplementFunctional significance of CT quantified bronchial wall thickening in bronchiectasisVSC Lam1, KWT Tsang2, GC Ooi3 Faculty of Medicine 1, Departments of Medicine2, and Diagnostic Radiology 3, TheUniversity of Hong Kong, Hong KongIntroduction: Qualitative evaluation of bronchial wall thickening (BWT) and extent of bronchiectasis have beenproven to have significant functional correlation in bronchiectasis. In asthma studies, BWT has also been noted tobe involved in airway remodeling. This study quantifies BWT on HRCT to determine its relationship with lungfunction and to compare its utility with qualitative evaluation.Method: 18 bronchiectatic [13 females (65.52 ± 11.45yrs)] underwent thoracic HRCT scan and lung function tests.BWT was graded in each lobe (n=6) using previously validated scoring system (0-3) based on thickness ofbronchial wall relative to the external diameter (EDB) of dilated bronchi perpendicular to the axial plane.Summation of scores from all 6 lobes provided the overall score. Internal bronchial diameter (IBD), EBD andaccompanying arterial diameter (AD) were also quantified on a workstation at pre-selected segmental bronchi. TheIBD and EBD of the thickest bronchus in each lobe were also measured. Relationships between HRCT and lungfunction parameters were evaluated.Results:  BWT score correlated with FVC, FEV1, FEF25-75 and PEF (r=-0.65, -0.76, -0.55, -0.75; p<0.05). MeanIBDT/EBDT of thickest bronchi, and mean IBDSB/ADSB and IBDSB/EBDSB of segmental bronchi were respectivelycorrelated with FEV1/FVC (r=0.51, 0.53 and 0.54, p<0.05) and FEF25-75 (r=0.52, 0.60, p<0.05 and r=0.47, p=0.05).Regression analysis revealed that BWT score was independently related to FVC, FEV1 and PFR while IBDSB/EBDSB and IBDT/EBDT were significant determinants of FEV1/FVC and FEF25-75 respectively. IBDSB/EBDSB wastherefore a measure of BWT and airflow obstruction in larger airways whilst IBDT/EBDT reflected smaller airwayobstruction.Conclusion:These results have confirmed the clinical utility of both qualitative and quantitative HRCT evaluationof BWT in bronchiectasis, which reflect airway remodeling in large and small airways. These HRCT parameterscould represent a non-invasive method of monitoring treatment response and disease progression of the bronchialtree.HRCT evaluation and immunohistochemistry of bronchiectactic airways: is therea relationship?VSC Lam1 KWT Tsang2, GC Ooi3 Faculty of Medicine 1, Departments of Medicine2, and Diagnostic Radiology 3, TheUniversity of Hong Kong, Hong KongIntroduction: This study evaluates the relationships between HRCT parameters and collagen IV density in bron-chiectatic airways.Method: 18 bronchiectatic [13 females (65.52 ± 11.45yrs)] subjects underwent thoracic HRCT scan andendobronchial biopsies (EBB). 15 [5 females (57.46 ± 11.99 yrs)] otherwise healthy patients investigated forsuspected lung cancer served as controls for EBB. Extent of bronchiectasis, bronchial wall thickening (BWT),global bronchiectasis score and small airway abnormalities on HRCT were qualitatively graded in bronchiectasissubjects. EBBs of all subjects and controls were stained with mouse anti-collagen IV antibodies, amplified usingLSAB method. Each section was divided into zone 1 [0-8µm below basement membrane (BM)] and zone 2[9-16µm below BM]. Positively stained collagen IV density, colour saturation, intensity of staining, and collagenfibril density were obtained for each zone using QWIN image analysis package. Correlation between immuno-histochemistry and HRCT findings were evaluated.Results: Bronchiectatic subjects had significantly higher collagen IV density and fibril density in zones 1 (p <0.01)and 2 (p <0.01) compared with controls. There was no difference between saturation and intensity between the 2groups. Zone 1 collagen IV density was correlated with BWT score (r=0.51, p=0.03), and mean collagen IV density(zone 1 & 2) was associated with global bronchiectasis score (r=0.53, p=0.02).Conculsion: Collagen density was higher in bronchiectatic airways than in normal airways. There is an associationbetween immunohistochemistry of EBBs and HRCT parameters in bronchiectasis whereby the BWT and globalbronchiectasis scores reflected collagen IV deposition, and probably airway remodelling.RM-11RM-12

Functional significance of CT quantified bronchial wall thickening in bronchbiectasis

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Functional significance of CT quantified bronchial wall thickening in bronchbiectasis

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