Korean J Radiol.  2011 Jun;12(3):386-389. 10.3348/kjr.2011.12.3.386.

Redistributed Regional Ventilation after the Administration of a Bronchodilator Demonstrated on Xenon-Inhaled Dual-Energy CT in a Patient with Asthma

• Goo HW
• Yu J

• KMID: 1122337
• DOI: http://doi.org/10.3348/kjr.2011.12.3.386

Abstract

We report here on the redistributed regional ventilation abnormalities after the administration of a bronchodilator and as seen on xenon-inhaled dual-energy CT in a patient with asthma. The improved ventilation seen in the right lower lobe and the decreased ventilation seen in the right middle lobe after the administration of a bronchodilator on xenon-inhaled dual-energy CT could explain a positive bronchodilator response on a pulmonary function test. These changes may reflect the heterogeneity of the airway responsiveness to a bronchodilator in patients with asthma.

Keyword

Xenon ventilation CT; Asthma; Bronchodilator; Dual-energy CT; Dual-source CT; Thorax CT

MeSH Terms

Albuterol/*administration & dosage
Asthma/*physiopathology/*radiography
Bronchodilator Agents/*administration & dosage
Child
Female
Humans
Pulmonary Ventilation
Radiation Dosage
Tomography, X-Ray Computed/*methods
Xenon/diagnostic use

Figure

• 

  Fig. 1 7-year-old girl with bronchial asthma. A. Coronal weighted-average CT image after administration of bronchodilator shows wall thickenings of central airways (arrows). Hyperlucency that suggests air trapping is noted in right middle lobe. B. Axial weighted-average CT image before administration of bronchodilator shows focal hyperlucent areas in superior segment of right lower lobe (arrows) and in left upper lobe lingular division (arrowheads). C. Axial xenon map before administration of bronchodilator reveals severe ventilation defect in superior segment of right lower lobe (arrows) and milder subsegmental ventilation defect in left upper lobe lingular division (arrowheads). D. Axial xenon map after administration of bronchodilator demonstrates redistributed regional ventilation in right lung. Xenon values in superior segment of right lower lobe are remarkably increased, while those in right middle lobe and especially those in lateral segment (arrows) are decreased. On other hand, subsegmental defect in left upper lobe lingular division (arrowheads) appears unchanged. Of note, xenon values in normally ventilated lung regions appear slightly lower than those on xenon map before administration of bronchodilator (C) and this was probably due to slight difference in inhaled xenon concentration and respiration level between two dual-energy CT scans.

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