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Evidence for dysanapsis using computed tomographic imaging of the airways in older ex-smokers

¹School of Human Kinetics, University of British Columbia; ; ²Department of Radiology, Vancouver General Hospital; ; ³The James Hogg iCAPTURE Centre for Cardiovascular and Pulmonary Research at the Heart and Lung Centre of St. Paul's Hospital; and ; ⁴British Columbia Cancer Agency, Vancouver, British Columbia, Canada

Submitted 25 May 2009 ; accepted in final form 11 September 2009

We sought to determine the relationship between lung size and airway size in men and women of varying stature. We also asked if men and women matched for lung size would still have differences in airway size and if so where along the pulmonary airway tree would these differences exist. We used computed tomography to measure airway luminal areas of the large and central airways. We determined airway luminal areas in men (n = 25) and women (n = 25) who were matched for age, body mass index, smoking history, and pulmonary function and in a separate set of men (n = 10) and women (n = 11) who were matched for lung size. Men had greater values for the larger airways and many of the central airways. When male and female subjects were pooled there were significant associations between lung size and airway size. Within the male and female groups the magnitudes of these associations were decreased or nonsignificant. In males and females matched for lung size women had significantly smaller airway luminal areas. The larger conducting airways in females are significantly smaller than those of males even after controlling for lung size.

airway luminal area; airway-parenchymal dysanapsis; three-dimensional computed tomography