High-resolution CT pulmonary findings in children with severe asthma

Objective: To compare quantitative CT parameters between children with severe asthma and healthy subjects, correlating to their clinical features. Methods: We retrospectively analyzed CT data from 19 school-aged children (5-17 years) with severe asthma and 19 control school-aged children with pectus excavatum. The following CT parameters were evaluated: total lung volume (TLV), mean lung density (MLD), CT air trapping index (AT%) (attenuation <= 856 HU), airway wall thickness (AWT), and percentage of airway wall thickness (AWT%). Multi-detector computed tomography (MDCT) data were correlated to the following clinical parameters: forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), forced expiratory flow at 25-75% (FEF 25-75%), FEV1/FVC ratio, sputum and bronchoalveolar lavage analysis, serum IgE levels, and previous hospitalizations due to asthma. Results: Asthma patients presented higher mean values of AT% (23.8 +/- 6.7% vs. controls, 9.7 +/- 3.2%), AWT (1.46 +/- 0.22 mm vs. controls, 0.47 +/- -735 +/- 28 HU vs. controls, -666 +/- 19 HU). Mean AT% was 29.0 +/- 4.7% in subjects with previous hospitalization against 19.2 +/- 5.0% in those with no prior hospitalization (p < 0.001). AT% presented very strong negative correlations with FVC (r = -0.933, p < 0.001) and FEV1 (r = -0.841, p < 0.001) and a moderate correlation with FEF 25-75% (r = -0.608, p = 0.007). AT% correlation with FEV1/FVC ratio and serum IgE was weak (r = -0.184, p = 0.452, and r = -0.363, p = 0.202) Conclusion: Children with severe asthma present differences in quantitative chest CT scans compared to healthy controls with strong correlations with pulmonary function tests and previous hospitalizations due to asthma. (C) 2020 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda.