ABNORMALITIES OF THE AIRWAYS AND LUNG PARENCHYMA IN ASTHMATICS - CT OBSERVATIONS IN 50 PATIENTS AND INTEROBSERVER AND INTRAOBSERVER VARIABILITY

The purpose of the study was to evaluate the CT abnormalities of airwa ys and lung parenchyma in asthmatic patients and to assess inter- and intraobserver variability for these abnormalities. The CT scans of 50 asthmatic patients and 10 healthy volunteers were assessed independent ly by four independent chest radiologists who were masked with respect to the clinical information. Bronchiectasis involving mostly subsegme ntal distal bronchi was noted in 28.5% of the asthmatic subjects and n one of the non-asthmatics. Bronchial wall thickening, small centrilobu lar opacities and decreases lung attenuation were observed in 82%, 21% and 31% of asthmatic patients respectively, compared with 7%, 5% and 7% of healthy subjects. The intra- and interobserver agreements for th ese four CT abnormalities were measured by the kappa statistic and ran ged from 0.60 and 0.79 and from 0.40 to 0.64, respectively. It is conc luded that asthmatic patients may exhibit bronchial wall thickening, b ronchiectasis and morphological abnormalities suggestive of distal air ways disease that can be assessed on CT scans with a clinically accept able observer variability.