Bronşial astma tanısıyla izlenen remisyondaki hastalarda ekspirium-yüksek resolüsyonlu bilgisayarlı tomografinin hava hapsinin gösterilmesindeki rolü ve solunum fonksiyon testi ile karşılaştırılması

Abstract

8.SUMMARY Asthma is one of the most frequent inflammatory airway disease. Paroxysmal dispnea, cough and wheezing are the most common symptoms. The beginning of asthma is usually in the childhood period. Airway inflammation is the most popular assumed hypothesis of pathogenesis. Chronic airway inflammation causes to histopathologic airway changes. There may be parenchymal regions in which air is trapped and cannot be exhaled, named air-trapping regions. Pulmonary function test is the useful method to evaluate asthmatic patient, which is used to evaluate the effectiveness of the therapy. HRCT is the gold standard evaluation method of the lung parenchyma. The HRCT scans obtained in expiration is helpful in the detection of the air-trapping regions. The normal lung parenchymal density increases with expiration, but the air-trapping regions. We evaluated 47 patients, which have normal or mild pulmonary function test abnormalities, if they have air trapping areas or not in expirium HRCT. The patients' age distribution was between 6 and 18 years. Thirty male and 17 female patients diagnosed and treated as asthma were included. All patients underwent HRCT study in first two days of pulmonary function test. The HRCT scans obtained five in inspiration and five in expiration were evaluated with semi-quantitative grid method. The expirium rate and expirium score were calculated. The air-trapping rate and air-trapping score were determined. The patients divided in three groups according to their air-trapping score (minimum 0, maximum 2). Each group was compared with each another if there is a relationship in pulmonary function test parameters and expirium scores. The densitometric analysis was performed in the normal and air- trapping regions. There were no statistically significant differences between three groups compared on the pulmonary function test parameters (p>0.05). There was a significant difference in expirium score between two groups which have air-trapping score 0 and 2, and 1 and 2. This result is concordant with the insufficient expiration in patient with high air trapping score. Twenty-five out of 47 patients have air-trapping regions, whereas 22 patients have not. Fourteen out of 25 patients with air-trapping, have some abnormalities in their 42pulmonary function tests. The half of patients with no air-trapping has some pulmonary function test abnormalities. The densitometric analysis reveals that there is a significant difference in the attenuation of normal and air-trapping region in expiration (p< 0.05). As a result there cannot be found any relationship between pulmonary function test abnormalities and air-trapping. The air-trapping cannot be predicted from pulmonary function test. 43