PDF herunterladen
Semin Respir Crit Care Med 2003; 24(5): 473-488
DOI: 10.1055/s-2004-815599
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Imaging of the Small Airways

Johny A. Verschakelen
  • Department of Radiology, University Hospitals, Leuven, Belgium
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
15. Januar 2004 (online)

    Lizenzen und Reprints

ABSTRACT

Small airways disease (SAD) is defined as a pathologic condition in which the small conducting airways are affected either primarily or as part of other pulmonary changes. Diagnosis is often difficult because the many histopathologic subtypes that have been described often lack obvious clinical or imaging correlates and because widespread involvement is needed before clinical symptoms and abnormalities on pulmonary function testing occur. High-resolution computed tomography (HRCT) can be helpful to detect, characterize, and quantify small airways involvement. These airways may become visible directly when inflammation of the bronchiolar wall and accompanying exudates develop. Obstruction of the small airways may be detected indirectly by HRCT when it causes regional underventilation resulting in reduced perfusion. This article discusses the direct and indirect HRCT signs of small airways involvement and, based on the fundamental differences between these signs, gives a short review of the HRCT features of the most important diseases that can affect the small airways.

KEYWORDS

Computed tomography - small airways disease - bronchiolitis

REFERENCES

  • 1 Lange W. Ueber eine eigenthumliche Erkrankung der kleinen Bronchien und Bronchiolen (bronchitis et bronchiolitis obliterans).  Dtsch Arch Klin Med . 1901;  70 342-364
    PubMedGoogle Scholar
  • 2 Baar H S, Galindo J. Bronchiolitis fibrosa obliterans.  Thorax . 1966;  21 209-214
    PubMedGoogle Scholar
  • 3 Gosink B B, Friedman P J, Liebow A A. Bronchiolitis obliterans: roentgenologic-pathologic correlation.  Am J Roentgenol Radium Ther Nucl Med . 1973;  117 816-832
    PubMedGoogle Scholar
  • 4 Garg K, Lynch D A, Newell J D. et al . Proliferative and constrictive bronchiolitis: classification and radiologic features.  AJR Am J Roentgenol . 1994;  162 803-808
    PubMedGoogle Scholar
  • 5 Epler G R, Colby T V, McLoud T C. et al . Bronchiolitis obliterans-organizing pneumonia.  N Engl J Med . 1985;  312 152-158
    CrossrefPubMedGoogle Scholar
  • 6 Sulavik S B. The concept of “organizing pneumonia.” Chest .  1989;  96 967-969
    PubMedGoogle Scholar
  • 7 Davison A G, Heard B E, McAllister W A, Turner-Warwick M E. Cryptogenic organizing pneumonitis.  Q J Med . 1983;  52(207) 382-394
    PubMedGoogle Scholar
  • 8 Geddes D M. BOOP and COP.  Thorax . 1991;  46 545-547
    PubMedGoogle Scholar
  • 9 ATS/ERS (American Thoracic Society/European Respiratory Society) International Multidisciplinary Consensus Classification of Idiopathic Interstitial Pneumonias.  Am J Respir Crit Care Med . 2002;  165 277-304
    PubMedGoogle Scholar
  • 10 Hansell D M, Rubens M B, Padley S PG. et al . Obliterative bronchiolitis: individual CT signs of small airways disease and functional correlation.  Radiology . 1997;  203 721-726
    PubMedGoogle Scholar
  • 11 Myers J L, Colby T V. Pathologic manifestations of bronchiolitis, constrictive bronchiolitis, cryptogenic organizing pneumonia, and diffuse panbronchiolitis.  Clin Chest Med . 1993;  14 611-622
    PubMedGoogle Scholar
  • 12 Worthy S A, Muller N L. Small airway diseases.  Radiol Clin North Am . 1998;  36 163-173
    CrossrefPubMedGoogle Scholar
  • 13 Hwang J H, Kim T S, Lee K S. et al . Bronchiolitis in adults: pathology and imaging.  J Comput Assist Tomogr . 1997;  21 913-919
    CrossrefPubMedGoogle Scholar
  • 14 Poletti V, Zompatori M, Cancellieri A. Clinical spectrum of adult chronic bronchiolitis.  Sarcoidosis Vasc Diffuse Lung Dis . 1999;  16 183-196
    PubMedGoogle Scholar
  • 15 Muller N L, Miller R R. Diseases of the bronchioles: CT and histopathologic findings.  Radiology . 1995;  196 3-12
    PubMedGoogle Scholar
  • 16 Webb W R, Gamsu G, Wall S D. et al . CT of a bronchial phantom: factors affecting appearance and size measurements.  Invest Radiol . 1984;  19 394-398
    PubMedGoogle Scholar
  • 17 Seneterre E, Paganin F, Bruel J M. et al . Measurement of the internal size of bronchi using high-resolution computed tomography (HRCT).  Eur Respir J . 1994;  7 596-600
    CrossrefPubMedGoogle Scholar
  • 18 Kang E Y, Miller R R, Muller N L. Bronchiectasis: pathologic findings in resected specimens.  Radiology . 1995;  195 649-654
    CrossrefPubMedGoogle Scholar
  • 19 Grenier P, Cordeau M P, Beigelman C. High-resolution computed tomography of the airways.  J Thorac Imaging . 1993;  8 213-229
    PubMedGoogle Scholar
  • 20 Miller W S. The Lung.  2nd ed. Springfield: CC Thomas 1947: 203-205
    Google Scholar
  • 21 Gruden J F, Webb W R, Warnock M. Centrilobular opacities in the lung on high-resolution CT: diagnostic considerations and pathologic correlation.  AJR Am J Roentgenol . 1994;  162 569-574
    PubMedGoogle Scholar
  • 22 Itoh H, Murata K, Konishi J. et al . Diffuse lung disease: pathologic basis for the high-resolution computed tomography findings.  J Thorac Imaging . 1993;  8 176-188
    PubMedGoogle Scholar
  • 23 Murata K, Itoh H, Todo G. et al . Centrilobular lesions of the lung: demonstration by high-resolution CT and pathologic correlation.  Radiology . 1986;  161 641-645
    CrossrefPubMedGoogle Scholar
  • 24 Collins J. CT signs and patterns of lung disease.  Radiol Clin North Am . 2001;  39 1115-1135
    CrossrefPubMedGoogle Scholar
  • 25 Lynch D A, Webb W R, Gamsu G. et al . Computed tomography in pulmonary sarcoidosis.  J Comput Assist Tomogr . 1989;  13 405-410
    CrossrefPubMedGoogle Scholar
  • 26 Stein M G, Mayo J, Muller N. et al . Pulmonary lymphangitic spread of carcinoma: appearance on CT scans.  Radiology . 1987;  162 371-375
    PubMedGoogle Scholar
  • 27 Connolly S, Manson D, Eberhard A. et al . CT appearance of pulmonary vasculitis in children.  AJR Am J Roentgenol . 1996;  167 901-904
    PubMedGoogle Scholar
  • 28 Frazier A A, Rosado-de-Christenson M L, Galvin J R. et al . Pulmonary angiitis and granulomatosis: radiologic-pathologic correlation.  Radiographics . 1998;  18 687-710
    PubMedGoogle Scholar
  • 29 Kushihashi T, Munechika H, Ri K. et al . Bronchioalveolar adenoma of the lung: CT-pathologic correlation.  Radiology . 1994;  193 789-793
    PubMedGoogle Scholar
  • 30 Alasaly K, Muller N, Ostrow D N. et al . Cryptogenic organizing pneumonia: a report of 25 cases and a review of the literature.  Medicine (Baltimore) . 1995;  74 201-211
    CrossrefPubMedGoogle Scholar
  • 31 Lee K S, Kullnig P, Hartman T E. et al . Cryptogenic organizing pneumonia: CT findings in 43 patients.  AJR Am J Roentgenol . 1994;  162 543-546
    PubMedGoogle Scholar
  • 32 Muller N L, Staples C A, Miller R R. Bronchiolitis obliterans organizing pneumonia: CT features in 14 patients.  AJR Am J Roentgenol . 1990;  154 983-987
    PubMedGoogle Scholar
  • 33 Hansell D M, Wells A U, Padley S P. et al . Hypersensitivity pneumonitis: correlation of individual CT patterns with functional abnormalities.  Radiology . 1996;  199 123-128
    CrossrefPubMedGoogle Scholar
  • 34 Hartman T E, Tazelaar H D, Swensen S J. et al . Cigarette smoking: CT and pathologic findings of associated pulmonary diseases.  Radiographics . 1997;  17 377-390
    PubMedGoogle Scholar
  • 35 Howling S J, Hansell D M, Wells A U. et al . Follicular bronchiolitis: thin-section CT and histologic findings.  Radiology . 1999;  212 637-642
    PubMedGoogle Scholar
  • 36 Nishimura K, Kitaichi M, Izumi T. et al . Diffuse panbronchiolitis: correlation of high-resolution CT and pathologic findings.  Radiology . 1992;  184 779-785
    PubMedGoogle Scholar
  • 37 Remy-Jardin M, Remy J, Wallaert B. et al . Subacute and chronic bird breeder hypersensitivity pneumonitis: sequential evaluation with CT and correlation with lung function tests and bronchoalveolar lavage.  Radiology . 1993;  189 111-118
    CrossrefPubMedGoogle Scholar
  • 38 Davies C WH, Tasker A D, Padley S PG. et al . Air trapping in sarcoidosis on computed tomography: correlation with lung function.  Clin Radiol . 2000;  55 217-221
    CrossrefPubMedGoogle Scholar
  • 39 Gleeson F V, Traill Z C, Hansell D M. Expiratory CT evidence of small airways obstruction in sarcoidosis.  AJR Am J Roentgenol . 1996;  166 1052-1054
    CrossrefPubMedGoogle Scholar
  • 40 Marti-Bonmati L, Ruiz Perales F, Catala F. et al . CT findings in Swyer-James syndrome.  Radiology . 1989;  172 477-480
    PubMedGoogle Scholar
  • 41 Padley S P, Adler B D, Hansell D M. et al . Bronchiolitis obliterans: high resolution CT findings and correlation with pulmonary function tests.  Clin Radiol . 1993;  47 236-240
    CrossrefPubMedGoogle Scholar
  • 42 Stern E J, Frank M S. Small-airways disease of the lungs: findings at expiratory CT.  AJR Am J Roentgenol . 1994;  163 37-41
    PubMedGoogle Scholar
  • 43 Austin J H, Muller N L, Friedman P J. et al . Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society.  Radiology . 1996;  200 327-331
    CrossrefPubMedGoogle Scholar
  • 44 Worthy S A, Muller N L, Hartman T E. et al . Mosaic attenuation pattern on thin-section CT scans of the lung: differentiation among infiltrative lung, airway, and vascular diseases as a cause.  Radiology . 1997;  205 465-470
    CrossrefPubMedGoogle Scholar
  • 45 Primack S L, Muller N L, Mayo J R. et al . Pulmonary parenchymal abnormalities of vascular origin: high-resolution CT findings.  Radiographics . 1994;  14 739-746
    PubMedGoogle Scholar
  • 46 Mandel J, Mark E J, Hales C A. Pulmonary veno-occlusive disease.  Am J Respir Crit Care Med . 2000;  162 1964-1973
    CrossrefPubMedGoogle Scholar
  • 47 Sherrick A D, Swensen S J, Hartman T E. Mosaic pattern of lung attenuation on CT scans: frequency among patients with pulmonary artery hypertension of different causes.  AJR Am J Roentgenol . 1997;  169 79-82
    CrossrefPubMedGoogle Scholar
  • 48 Dennie C J, Veinot J P, McCormack D G. et al . Intimal sarcoma of the pulmonary arteries seen as a mosaic pattern of lung attenuation on high-resolution CT.  AJR Am J Roentgenol . 2002;  178 1208-1210
    PubMedGoogle Scholar
  • 49 Guckel C, Wells A U, Taylor D A. et al . Mechanism of mosaic attenuation of the lungs on computed tomography in induced bronchospasm.  J Appl Physiol . 1999;  86 701-708
    PubMedGoogle Scholar
  • 50 Arakawa H, Webb W R. Air trapping on expiratory high-resolution CT scans in the absence of inspiratory scan abnormalities: correlation with pulmonary function tests and differential diagnosis.  AJR Am J Roentgenol . 1998;  170 1349-1353
    PubMedGoogle Scholar
  • 51 Desai S R, Hansell D M. Small airways disease: expiratory computed tomography comes of age.  Clin Radiol . 1997;  52 332-337
    CrossrefPubMedGoogle Scholar
  • 52 Lucidarme O, Coche E, Cluzel P. et al . Expiratory CT scans for chronic airway disease: correlation with pulmonary function test results.  AJR Am J Roentgenol . 1998;  170 301-307
    PubMedGoogle Scholar
  • 53 Verschakelen J A, Scheinbaum K, Bogaert J. et al . Expiratory CT in cigarette smokers: correlation between areas of decreased lung attenuation, pulmonary function tests and smoking history.  Eur Radiol . 1998;  8 1391-1399
    CrossrefPubMedGoogle Scholar
  • 54 Arakawa H, Webb W R, McCowin M. et al . Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans.  Radiology . 1998;  206 89-94
    CrossrefPubMedGoogle Scholar
  • 55 Stern E J, Swensen S J, Hartman T E. et al . CT mosaic pattern of lung attenuation: distinguishing different causes.  AJR Am J Roentgenol . 1995;  165 813-816
    PubMedGoogle Scholar
  • 56 Coche E E, Muller N L, Kim K I. et al . Acute pulmonary embolism: ancillary findings at spiral CT.  Radiology . 1998;  207 753-758
    PubMedGoogle Scholar
  • 57 Arakawa H, Kurihara Y, Sasaka K. et al . Air trapping on CT of patients with pulmonary embolism.  AJR Am J Roentgenol . 2002;  178 1201-1207
    PubMedGoogle Scholar
  • 58 Webb W R, Stern E J, Kanth N. et al . Dynamic pulmonary CT: findings in healthy adult men.  Radiology . 1993;  186 117-124
    PubMedGoogle Scholar
  • 59 Lee K W, Chung S Y, Yang I. et al . Correlation of aging and smoking with air trapping at thin-section CT of the lung in asymptomatic subjects.  Radiology . 2000;  214 831-836
    CrossrefPubMedGoogle Scholar
  • 60 Grenier P A, Beigelman-Aubry C, Fetita C. et al . New frontiers in CT imaging of airway disease.  Eur Radiol . 2002;  12 1022-1044
    CrossrefPubMedGoogle Scholar
  • 61 Loubeyre P, Revel D, Delignette A. et al . Bronchiectasis detected with thin-section CT as a predictor of chronic lung allograft rejection.  Radiology . 1995;  194 213-216
    PubMedGoogle Scholar
  • 62 Remy-Jardin M, Remy J, Cortet B. et al . Lung changes in rheumatoid arthritis: CT findings.  Radiology . 1994;  193 375-382
    CrossrefPubMedGoogle Scholar
  • 63 Logan P M, Primack S L, Miller R R. et al . Invasive aspergillosis of the airways: radiographic, CT, and pathologic findings.  Radiology . 1994;  193 383-388
    PubMedGoogle Scholar
  • 64 McGuinness G, Scholes J V, Garay S M. et al . Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients.  Radiology . 1994;  192 451-459
    CrossrefPubMedGoogle Scholar
  • 65 Primack S L, Logan P M, Hartman T E, Lee K S, Muller N L. Pulmonary tuberculosis and Mycobacterium avium-intracellulare: a comparison of CT findings.  Radiology . 1995;  194 413-417
    PubMedGoogle Scholar
  • 66 Aquino S L, Gamsu G, Webb W R. et al . Tree-in-bud pattern: frequency and significance on thin section CT.  J Comput Assist Tomogr . 1996;  20 594-599
    CrossrefPubMedGoogle Scholar
  • 67 Fitzgerald J E, King Jr E T, Lynch D A. et al . Diffuse panbronchiolitis in the United States.  Am J Respir Crit Care Med . 1996;  154 497-503
    CrossrefPubMedGoogle Scholar
  • 68 Murphy J M, Schnyder P, Verschakelen J. et al . Linear opacities on HRCT in bronchiolitis obliterans organising pneumonia.  Eur Radiol . 1999;  9 1813-1817
    CrossrefPubMedGoogle Scholar
  • 69 Logan P M, Miller R R, Muller N L. Cryptogenic organizing pneumonia in the immunocompromised patient: radiologic findings and follow-up in 12 patients.  Can Assoc Radiol J . 1995;  46 272-279
    PubMedGoogle Scholar
  • 70 Lohr R H, Boland B J, Douglas W W. et al . Organizing pneumonia: features and prognosis of cryptogenic, secondary, and focal variants.  Arch Intern Med . 1997;  157 1323-1329
    CrossrefPubMedGoogle Scholar
  • 71 Moon J, duBois R M, Colby T V. et al . Clinical significance of respiratory bronchiolitis on open lung biopsy and its relationship to smoking related interstitial lung disease.  Thorax . 1999;  54 1009-1014
    CrossrefPubMedGoogle Scholar
  • 72 Heyneman L E, Ward S, Lynch D A. et al . Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process?.  AJR Am J Roentgenol . 1999;  173 1617-1622
    PubMedGoogle Scholar
  • 73 Perez T, Remy-Jardin M, Cortet B. Airways involvement in rheumatoid arthritis: clinical, functional, and HRCT findings.  Am J Respir Crit Care Med . 1998;  157 1658-1665
    CrossrefPubMedGoogle Scholar
  • 74 Worthy S A, Flint J D, Muller N L. Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings.  Radiographics . 1997;  17 1359-1371
    PubMedGoogle Scholar
  • 75 Worthy S A, Park C S, Kim J S. et al . Bronchiolitis obliterans after lung transplantation: high-resolution CT findings in 15 patients.  AJR Am J Roentgenol . 1997;  169 673-677
    PubMedGoogle Scholar
  • 76 Stern E J, Muller N L, Swensen S J. et al . CT mosaic pattern of lung attenuation: etiologies and terminology.  J Thorac Imaging . 1995;  10 294-297
    PubMedGoogle Scholar
  • 77 Bankier A A, Van Muylem A, Knoop C. et al . Bronchiolitis obliterans syndrome in heart-lung transplant recipients: diagnosis with expiratory CT.  Radiology . 2001;  218 533-539
    PubMedGoogle Scholar
  • 78 Lee E S, Gotway M B, Reddy G P. et al . Early bronchiolitis obliterans following lung transplantation: accuracy of expiratory thin-section CT for diagnosis.  Radiology . 2000;  216 472-477
    PubMedGoogle Scholar
  • 79 Leung A N, Fisher K, Valentine V. et al . Bronchiolitis obliterans after lung transplantation: detection using expiratory HRCT.  Chest . 1998;  113 365-370
    PubMedGoogle Scholar
  • 80 Siegel M J, Bhalla S, Gutierrez F R. et al . Post-lung transplantation bronchiolitis obliterans syndrome: usefulness of expiratory thin-section CT for diagnosis.  Radiology . 2001;  220 455-462
    PubMedGoogle Scholar
  • 81 Hansell D M, Wells A U, Rubens M B. et al . Bronchiectasis: functional significance of areas of decreased attenuation at expiratory CT.  Radiology . 1994;  193 369-374
    CrossrefPubMedGoogle Scholar
  • 82 Im J G, Kim S H, Chung M J. et al . Lobular low attenuation of the lung parenchyma on CT: evaluation of forty-eight patients.  J Comput Assist Tomogr . 1996;  20 756-762
    CrossrefPubMedGoogle Scholar
  • 83 Roberts H R, Wells A U, Milne D G. et al . Airflow obstruction in bronchiectasis: correlation between computed tomography features and pulmonary function tests.  Thorax . 2000;  55 198-204
    CrossrefPubMedGoogle Scholar
  • 84 McDonagh J, Greaves M, Wright A R. et al . High-resolution computed tomography of the lungs in patients with rheumatoid arthritis and interstitial lung disease.  Br J Rheumatol . 1994;  33 118-122
    PubMedGoogle Scholar
  • 85 Perez T, Farre J M, Gosset P. et al . Subclinical alveolar inflammation in rheumatoid arthritis: superoxide anion, neutrophil chemotactic activity and fibronectin generation by alveolar macrophages.  Eur Respir J . 1989;  2 7-13
    PubMedGoogle Scholar
  • 86 Wolfe F, Schurle D RE, Lin J J. et al . Upper and lower airway disease in penicillamine treated patients with rheumatoid arthritis.  J Rheumatol . 1983;  10 406-410
    PubMedGoogle Scholar
  • 87 Hansell D M, Moskovic E. High-resolution computed tomography in extrinsic allergic alveolitis.  Clin Radiol . 1991;  43 8-12
    CrossrefPubMedGoogle Scholar
  • 88 Silver S F, Muller N L, Miller R R. et al . Hypersensitivity pneumonitis: evaluation with CT.  Radiology . 1989;  173 441-445
    PubMedGoogle Scholar
  • 89 Small J H, Flower C D, Traill Z C. et al . Air-trapping in extrinsic allergic alveolitis.  Clin Radiol . 1996;  51 684-688
    CrossrefPubMedGoogle Scholar
  • 90 Soleman A, Colby T V. Histologic diagnosis of extrinsic allergic alveolitis.  Am J Surg Pathol . 1988;  12 514-518
    PubMedGoogle Scholar
  • 91 Adler B D, Padley S P, Muller N L. et al . Chronic hypersensitivity pneumonitis: high-resolution CT and radiographic features in 16 patients.  Radiology . 1992;  185 91-95
    PubMedGoogle Scholar
  • 92 Lynch D A, Newell J D, Logan P M. et al . Can CT distinguish hypersensitivity pneumonitis from idiopathic pulmonary fibrosis?.  AJR Am J Roentgenol . 1995;  165 807-811
    PubMedGoogle Scholar
  • 93 Hansell D M, Milne D G, Wilsher M L. et al . Pulmonary sarcoidosis: morphologic associations of airflow obstruction at thin-section CT.  Radiology . 1998;  209 697-704
    CrossrefPubMedGoogle Scholar
  • 94 Carrington C B. Structure and function in sarcoidosis.  Ann N Y Acad Sci . 1976;  278 265-283
    CrossrefPubMedGoogle Scholar
  • 95 Magkanas E, Voloudaki A, Bouros D. et al . Correlation of expiratory high-resolution CT findings with inspiratory patterns and pulmonary function tests.  Acta Radiol . 2001;  42 494-501
    PubMedGoogle Scholar
  • 96 Carr D H, Hibon S, Rubens M. et al . Peripheral airways obstruction on high-resolution computed tomography in chronic severe asthma.  Respir Med . 1998;  92 448-453
    PubMedGoogle Scholar
  • 97 Gevenois P A, Scillia P, de Maertelaer V. et al . The effects of age, sex, lung size, and hyperinflation on CT lung densitometry.  AJR Am J Roentgenol . 1996;  167 1169-1173
    PubMedGoogle Scholar
  • 98 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 intra-observer variability.  Eur Radiol . 1996;  6 199-206
    PubMedGoogle Scholar
  • 99 Lynch D A, Newell J D, Tschomper B A. et al . Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects.  Radiology . 1993;  188 829-833
    PubMedGoogle Scholar
  • 100 Paganin F, Seneterre E, Chanez P. et al . Computed tomography of the lungs in asthma: influence of disease severity and etiology.  Am J Respir Crit Care Med . 1996;  153 110-114
    PubMedGoogle Scholar
  • 101 Park C S, Muller N L, Worthy S A. et al . Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings.  Radiology . 1997;  203 361-367
    PubMedGoogle Scholar
  • 102 Awadh N, Muller N L, Park C S. et al . Airway wall thickness in patients with near fatal asthma and control groups: assessment with high-resolution computed tomography.  Thorax . 1998;  53 248-253
    CrossrefPubMedGoogle Scholar
  • 103 Niimi A, Matsumoto H, Amitani R. et al . Airway wall thickness in asthma assessed by computed tomography.  Am J Respir Crit Care Med . 2000;  162 1518-1523
    PubMedGoogle Scholar
  • 104 Laurent F, Latrabe V, Raherison C. et al . Functional significance of air trapping detected in moderate asthma.  Eur Radiol . 2000;  10 1404-1410
    CrossrefPubMedGoogle Scholar
  • 105 Newman K B, Lynch D A, Newman L S. et al . Quantitative computed tomography detects air trapping due to asthma.  Chest . 1994;  106 105-109
    PubMedGoogle Scholar