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The total image score of EGPA patients was significantly higher than that of severe asthmatics (P0.05). In the radiological only and the clinical-radiological model, the area under the receiver operating characteristic (ROC) curves (AUCs) for the identification of EGPA and severe asthma were 0.904 [95% confidence interval (CI) 0.860 to 0.948] and 0.974 (95% CI 0.955 to 0.993), respectively. Lung HRCT scan is useful in differentiating EGPA from severe asthma. In patients with difficult-to-treat asthma, an HRCT scan of the thorax should be perform