Airflow limitation and airway dimensions in chronic obstructive pulmonary disease

Masaru Hasegawa, Yasuyuki Nasuhara, Yuya Onodera, Hironi Makita, Katsura Nagai, Satoshi Fuke, Yoko Ito, Tomoko Betsuyaku, Masaharu Nishimura

Research output: Contribution to journalArticlepeer-review

357 Citations (Scopus)


Rationale: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation caused by emphysema and/or airway narrowing. Computed tomography has been widely used to assess emphysema severity, but less attention has been paid to the assessment of airway disease using computed tomography. Objectives: To obtain longitudinal images and accurately analyze short axis images of airways with an inner diameter ≥ 2 mm located anywhere in the lung with new software for measuring airway dimensions using curved multiplanar reconstruction. Methods: In 52 patients with clinically stable COPD (stage I, 14; stage II, 22; stage III, 14; stage IV, 2), we used the software to analyze the relationship of the airflow limitation index (FEV1, % predicted) with the airway dimensions from the third to the sixth generations of the apical bronchus (B1) of the right upper lobe and the anterior basal bronchus (B8) of the right lower lobe. Measurements and Main Results: Airway luminal area (Ai) and wall area percent (WA%) were significantly correlated with FEV1 (% predicted). More importantly, the correlation coefficients (r) improved as the airways became smaller in size from the third (segmental) to sixth generations in both bronchi (Ai: r = 0.26, 0.37, 0.58, and 0.64 for B1; r = 0.60, 0.65, 0.63, and 0.73 for B8). Conclusions: We are the first to use three-dimensional computed tomography to demonstrate that airflow limitation in COPD ismore closely related to the dimensions of the distal (small) airways than proximal (large) airways.

Original languageEnglish
Pages (from-to)1309-1315
Number of pages7
JournalAmerican journal of respiratory and critical care medicine
Issue number12
Publication statusPublished - 2006 Jun 15
Externally publishedYes


  • Airway luminal area
  • Airway wall
  • Computed tomography
  • Multiplanar reconstruction
  • Small airway

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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