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Respirology. 2017 Jan;22(1):108-113. doi: 10.1111/resp.12875. Epub 2016 Aug 18.

Bronchoarterial ratio in never-smokers adults: Implications for bronchial dilation definition.

Author information

1
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
2
Division of Pulmonary Diseases & Critical Care, University of Texas Health Science Center, San Antonio, Texas, USA.
3
Division of Pulmonary & Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.
4
Department of Radiology, University of California, San Diego, California, USA.
5
Department of Radiology, Temple University Hospital, Philadelphia, Pennsylvania, USA.
6
Department of Radiology, National Jewish Health, Denver, Colorado, USA.
7
Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado, USA.
8
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Abstract

BACKGROUND AND OBJECTIVE:

Bronchiectasis manifests as recurrent respiratory infections and reduced lung function. Airway dilation, which is measured as the ratio of the diameters of the bronchial lumen (B) and adjacent pulmonary artery (A), is a defining radiological feature of bronchiectasis. A challenge to equating the bronchoarterial (BA) ratio to disease severity is that the diameters of airway and vessel in health are not established. We sought to explore the variability of BA ratio in never-smokers without pulmonary disease and its associations with lung function.

METHODS:

Objective measurements of the BA ratio on volumetric computed tomography (CT) scans and pulmonary function data were collected in 106 never-smokers. The BA ratio was measured in the right upper lobe apical bronchus (RB1) and the right lower lobe basal posterior bronchus. The association between the BA ratio and forced expiratory volume in 1 s (FEV1 ) was assessed using regression analysis.

RESULTS:

The BA ratio was 0.79 ± 0.16 and was smaller in more peripheral RB1 bronchi (P < 0.0001). The BA ratio was >1, a typical threshold for bronchiectasis, in 10 (8.5%) subjects. Subjects with a BA ratio >1 versus ≤1 had smaller artery diameters (P < 0.0001) but not significantly larger bronchial lumens. After adjusting for age, gender, race and height, the BA ratio was directly related to FEV1 (P = 0.0007).

CONCLUSION:

In never-smokers, the BA ratio varies by airway generation and is associated with lung function. A BA ratio >1 is driven by small arteries. Using artery diameter as reference to define bronchial dilation seems inappropriate.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00608764.

KEYWORDS:

bronchiectasis; bronchoarterial ratio; non-smoking; normal; volumetric computed tomography

PMID:
27538197
PMCID:
PMC5161710
DOI:
10.1111/resp.12875
[Indexed for MEDLINE]
Free PMC Article

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