Background

It is essential to recognize and treat findings that can simulate or worsen symptoms _to improve asthma control and thereby to reduce costs. Guidelines highlight a paranasal (PS) and chest computed tomography (CT) scan as a tool for disease evaluation and, although they suggest its indication in patients whom presentation is atypical, there are not well-defined criteria.

Objectives

To describe the most common findings in the PS and chest CT in severe asthma patients and to analyse the characteristics of asthmatics with the finding of nasal polyps or bronchiectasis.

Methods

We retrospectively reviewed the medical records of 161 adults with confirmed severe asthma who had undergone to PS and/or chest CT. Clinical data from their electronic health record and the findings from a PS and/or chest CT within the last five years were collected.

Results

In the PS CT, 70.5% of patients presented mucous thickening and 46.7% presented nasal polyps. Both findings were associated with male gender and level of blood eosinophils. In chest CT, 28% of individuals showed atelectasis, 16.5% air trapping, 17.7% affectation of the small airway, 11.6% pulmonary infiltrates and 10.4% emphysema. Bronchiectasis were identified in 60.4% of subjects, who were older and had poorer lung function.

Conclusion

Paranasal and thoracic computed tomography are important tools in the treatment of severe asthma because they allow us to detect highly prevalent findings in this disease that can lead to poorer control of it.

中文翻译：

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我们应该考虑对重度哮喘患者进行鼻旁和胸部计算机断层扫描吗？

背景

识别和治疗可以模拟或加重症状的发现_对于改善哮喘控制从而降低成本至关重要。指南强调了鼻旁（PS）和胸部计算机断层扫描（CT）扫描作为疾病评估的工具，尽管它们建议在表现不典型的患者中进行指征，但尚无明确的标准。

目标

描述重症哮喘患者在PS和胸部CT中最常见的发现，并通过发现鼻息肉或支气管扩张来分析哮喘患者的特征。

方法

我们回顾性分析了接受PS和/或胸部CT检查的161名确诊为严重哮喘的成年人的病历。收集他们过去五年来电子健康记录中的临床数据以及PS和/或胸部CT的发现。

结果

在PS CT中，70.5％的患者出现粘液增厚，46.7％的患者出现鼻息肉。两项发现均与男性性别和血液嗜酸性粒细胞水平有关。在胸部CT中，有28％的人表现为肺不张，16.5％的空气滞留，17.7％的小气道受累，11.6％的肺浸润和10.4％的肺气肿。在年龄较大且肺功能较差的受试者中，有60.4％的人患有支气管扩张。

结论

鼻旁和胸部计算机断层扫描是治疗严重哮喘的重要工具，因为它们使我们能够发现这种疾病的高度普遍发现，从而导致对它的控制较差。