CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types.

Reiff, D.B.; Wells, Adrian; Carr, Denis H.; Cole, P J; Hansell, David M.

doi:10.2214/ajr.165.2.7618537

Cited by 319 publications

(224 citation statements)

References 33 publications

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“…Given the good interobserver agreement for the CT features of bronchiectasis previously published [12][13][14], CTs were evaluated by a single experienced cardiothoracic radiologist.…”

Section: Sputum Processingmentioning

confidence: 99%

“…The presence of bronchiectasis was defined using established criteria [15,16]. The severity of bronchial dilatation (0: normal; 1: 1-26dia-meter of adjacent artery; 2: 2-36diameter of adjacent artery; 3: .36diameter of adjacent artery), and of bronchial wall thickening (0: normal; 1: ,0.56diameter of adjacent artery; 2: 0.5-16diameter of adjacent artery; 3: .16diameter of adjacent artery) was scored for each lobe using previously described criteria [14,17]. The extent of bronchiectasis [11], mucus plugging [18], sacculations/abscesses [11], mosaic perfusion [18] and collapse or consolidation were assessed on a lobar basis and the number of segments involved recorded.…”

Section: Sputum Processingmentioning

confidence: 99%

See 1 more Smart Citation

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Fowler¹,

French²,

Screaton³

et al. 2006

Eur Respir J

147

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The aim of the current study was to investigate the prevalence and clinical associations of nontuberculous mycobacteria (NTM) in a well-characterised cohort of patients with adult-onset bronchiectasis.The sputum of all patients attending a tertiary referral bronchiectasis clinic between April 2002 and August 2003 was examined for mycobacteria as part of an extensive diagnostic work-up. NTM-positive patients subsequently had further sputa examined. A modified bronchiectasis scoring system was applied to all high-resolution computed tomography (HRCT) scans from NTM-positive patients, and a matched cohort without NTM.Out of 98 patients attending the clinic, 10 had NTM in their sputum on first culture; of those, eight provided multiple positive cultures. Three patients were treated for NTM infection. A higher proportion of NTM-positive than -negative patients were subsequently diagnosed with cystic fibrosis (two out of nine versus two out of 75). On HRCT scoring, more patients in the NTMpositive group had peripheral mucus plugging than in the NTM-negative group.In the current prospective study of a large cohort of patients with bronchiectasis, 10% cultured positive for nontuberculous mycobacteria in a random clinic sputum sample. Few clinical parameters were helpful in discriminating between groups, except for a higher prevalence of previously undiagnosed cystic fibrosis and of peripheral mucus plugging on high-resolution computed tomography in the nontuberculous mycobacteria group.

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“…Given the good interobserver agreement for the CT features of bronchiectasis previously published [12][13][14], CTs were evaluated by a single experienced cardiothoracic radiologist.…”

Section: Sputum Processingmentioning

confidence: 99%

Section: Sputum Processingmentioning

confidence: 99%

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Fowler¹,

French²,

Screaton³

et al. 2006

Eur Respir J

147

View full text Add to dashboard Cite

show abstract

“…We used a simple radiological classification system to evaluate the severity of disease on HRCT. This score has limitations, as it only takes into account the number of lobes involved and the degree of dilatation (15). This score has been widely used in studies of non-CF bronchiectasis but takes into account far fewer variables than scoring systems used in CF, such as the Bhalla score (30).…”

Section: Discussionmentioning

confidence: 99%

“…The maximum score is 18 and minimum score is 1. This score has been used previously in studies of bronchiectasis (13)(14)(15)(16).…”

Section: Radiological Severitymentioning

confidence: 99%

The Bronchiectasis Severity Index. An International Derivation and Validation Study

Chalmers

Goeminne²,

Aliberti

et al. 2014

Am J Respir Crit Care Med

843

836

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Rationale: There are no risk stratification tools for morbidity and mortality in bronchiectasis. Identifying patients at risk of exacerbations, hospital admissions, and mortality is vital for future research.Objectives: This study describes the derivation and validation of the Bronchiectasis Severity Index (BSI).Methods: Derivation of the BSI used data from a prospective cohort study (Edinburgh, UK, 2008 enrolling 608 patients. Cox proportional hazard regression was used to identify independent predictors of mortality and hospitalization over 4-year follow-up. The score was validated in independent cohorts from Dundee, UK (n = 218); Leuven, Belgium (n = 253); Monza, Italy (n = 105); and Newcastle, UK (n = 126).Measurements and Main Results: Independent predictors of future hospitalization were prior hospital admissions, Medical Research Council dyspnea score greater than or equal to 4, FEV 1 , 30% predicted, Pseudomonas aeruginosa colonization, colonization with other pathogenic organisms, and three or more lobes involved on high-resolution computed tomography. Independent predictors of mortality were older age, low FEV 1 , lower body mass index, prior hospitalization, and three or more exacerbations in the year before the study. The derived BSI predicted mortality and hospitalization: area under the receiver operator characteristic curve (AUC) 0.80 (95% confidence interval, 0.74-0.86) for mortality and AUC 0.88 (95% confidence interval, 0.84-0.91) for hospitalization, respectively.There was a clear difference in exacerbation frequency and quality of life using the St. George's Respiratory Questionnaire between patients classified as low, intermediate, and high risk by the score (P , 0.0001 for all comparisons). In the validation cohorts, the AUC for mortality ranged from 0.81 to 0.84 and for hospitalization from 0.80 to 0.88. Conclusions:The BSI is a useful clinical predictive tool that identifies patients at risk of future mortality, hospitalization, and exacerbations across healthcare systems.

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“…For example, atypical mycobacteria may favour the right middle lobe and the lingula 45. Despite identification of these key features on CT and extensive testing, no underlying aetiology is found in a large proportion of patients with bronchiectasis 46. The prevalence of idiopathic bronchiectasis varies amongst cohorts (32%‐66%) likely owing to geographic variations, diagnostic algorithms and other determinants 30, 47, 48, 49, 50, 51…”

Section: Diagnostic Approachmentioning

confidence: 99%

Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know

et al. 2017

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SummaryAimsNon‐cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT).MethodsFor this review, trials and reports were identified from PubMed/Medline and ClinicalTrials.gov from the US NIH and the Cochrane Register of Controlled Trials. The search used keywords: bronchiectasis, non‐cystic fibrosis bronchiectasis, chronic pulmonary infection and computed tomography. No date/language restrictions were used.ResultsNon‐cystic fibrosis bronchiectasis often coexists with other respiratory conditions, such as chronic obstructive pulmonary disease. The prevalence of NCFB is increasing, particularly in women and older individuals, possibly as a result of increased physician awareness and widespread use of CT, which is the gold standard for the diagnosis of NCFB. CT can assist in identifying an underlying cause of NCFB and determining the extent and severity of the disease.DiscussionNon‐cystic fibrosis bronchiectasis should be suspected in the primary care setting in patients with chronic cough, purulent sputum and frequent respiratory infections that tend to resolve slowly or partially. Early diagnosis and determination of the extent and severity of the disease by CT and other tests are critical to establish therapy to improve quality of life and potentially slow progressive decline of lung function in patients with NCFB .

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CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types.

Cited by 319 publications

References 33 publications

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

Nontuberculous mycobacteria in bronchiectasis: prevalence and patient characteristics

The Bronchiectasis Severity Index. An International Derivation and Validation Study

Suspecting non-cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know

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