Imaging of Small Airways and Emphysema

Edwards, Rachael; Kicska, Gregory; Schmidt, Rodney A.; Pipavath, Sudhakar

doi:10.1016/j.ccm.2015.02.013

Cited by 10 publications

(10 citation statements)

References 62 publications

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“…With more commonplace use of CT in cats, we are recognizing some features similar to those described in humans. Paired inspiratory and expiratory scans and thin section reconstruction (0.625-2 mm slice thickness) 27 provide optimal detail. Normal bronchioles in humans and cats are below the limits of resolution on HRCT, but with dilatation, mural thickening, and intraluminal plugging, small airways become visible.…”

Section: Imaging and Histologymentioning

confidence: 99%

“…5,14,27 Indirect signs reflect changes to the pulmonary parenchyma distal to the diseased bronchiole and include mosaic attenuation (because of air trapping) or, in the setting of bronchiolar disorders, rarely mosaic perfusion. 27 Because air trapping may be imperceptible on inspiratory images, expiratory scans are crucial to accentuate air trapping. 8 Direct findings reflect inflammation or proliferative changes within the bronchiolar lumens, whereas indirect findings reflect fibrosis within the bronchiolar wall (eg, constrictive bronchiolitis).…”

Section: Imaging and Histologymentioning

confidence: 99%

“…25,35 High-resolution CT predominantly identifies mosaic attenuation, bronchiolectasis or bronchiectasis, and air trapping accentuated on expiratory views. 10,27 Most cases are progressive, poorly responsive to corticosteroids and result in respiratory failure and death. 36 One cat in a case series had suppurative bronchopneumonia, bronchiolitis obliterans, and pulmonary fibrosis; it is unclear if this cat had a primary bronchiolar disorder or an ILD with secondary bronchiolar involvement.…”

Section: Classification Of Bronchiolar Disordersmentioning

confidence: 99%

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Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Reinero

Masseau

Grobman

et al. 2019

Veterinary Internal Medicne

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This Perspectives in Veterinary Medicine article seeks to define, describe putative causes, and discuss key diagnostic tests for primary and secondary bronchiolar disorders to propose a classification scheme in cats with support from a literature review and case examples. The small airways (bronchioles with inner diameters <2 mm), located at the transitional zone between larger conducting airways and the pulmonary acinus, have been overlooked as major contributors to clinical syndromes of respiratory disease in cats. Because the trigger for many bronchiolar disorders is environmental and humans live in a shared environment with similar susceptibility, understanding these diseases in pet cats has relevance to One Health. Thoracic radiography, the major imaging modality used in the diagnostic evaluation of respiratory disease in cats, has low utility in detection of bronchiolar disease. Computed tomography (CT) with paired inspiratory and expiratory scans can detect pathology centered on small airways. In humans, treatment of bronchiolar disorders is not well established because of heterogeneous presentations and often late definitive diagnosis. A review of the human and veterinary medical literature will serve as the basis for a proposed classification scheme in cats. A case series of cats with CT or histopathologic evidence of bronchiolar lesions or both, either as a primary disorder or secondary to extension from large airway disease or interstitial lung disease, will be presented. Future multi‐institutional and multidisciplinary discussions among clinicians, radiologists, and pathologists will help refine and develop this classification scheme to promote early and specific recognition and optimize treatment.

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Section: Imaging and Histologymentioning

confidence: 99%

Section: Imaging and Histologymentioning

confidence: 99%

Section: Classification Of Bronchiolar Disordersmentioning

confidence: 99%

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Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Reinero

Masseau

Grobman

et al. 2019

Veterinary Internal Medicne

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“…Radiographs are considered to be of low utility to detect bronchiolar disease in humans . In the current study, radiography led to an underestimation of the number of “tree‐in‐bud” lesions in 24/36 cats; moreover, its presence was completely missed in 6/36 animals.…”

Section: Discussionmentioning

confidence: 56%

The computed tomographic “tree‐in‐bud” pattern: Characterization and comparison with radiographic and clinical findings in 36 cats

Hahn

Specchi²,

Masseau

et al. 2017

Vet Radiology Ultrasound

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In humans, a CT "tree-in-bud" pattern has been described as a characteristic of centrilobular bronchiolar dilation, with bronchiolar plugging by mucus, pus, or fluid. Aims of this retrospective, descriptive, multi-center study were to characterize the CT appearance of a "tree-in-bud" pattern in a group of cats, and compare this pattern with radiographic and clinical findings. Databases from four hospitals were searched during the period of January 2012 to September 2015 and cats with thoracic radiographs, thoracic CT scans and CT reports describing findings consistent with a "tree-in-bud" pattern were included. Images were reviewed by two veterinary radiologists and characteristics were recorded based on consensus. Clinical findings were recorded by one observer from each center. Thirty-six cats met inclusion criteria. Six cats were asymptomatic, 12 were diagnosed with bronchial disease and 23 were suspected to have bronchial disease. Right cranial and right caudal lung lobes were most commonly affected on both imaging modalities. Localization of the "tree-in-bud" pattern was most often peripheral. On radiographs, the CT "tree-in-bud" pattern often appeared as soft-tissue opacity nodules; their number and affected pulmonary segments were often underestimated compared with CT. In conclusion, the "tree-in-bud" pattern should be considered as a differential diagnosis for radiographic soft tissue opaque nodules in feline lungs. Based on lesion localization and presence or suspicion of a concomitant bronchial disease for cats in this sample, authors propose that the CT "tree-in-bud" pattern described in humans is also a characteristic of bronchial or bronchiolar plugging and bronchial disease in cats.

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“…2). [5][6][7][8] The centrilobular nodules appear separated by several millimeters from the pleural surfaces, fissures, and interlobular septa. They may be of soft tissue or ground-glass attenuation, and are usually millimetric and ill defined.…”

Section: Imaging Of the Small Airwaysmentioning

confidence: 99%

Many Faces of Bronchiolitis and Organizing Pneumonia

Cordier¹,

Cottin²,

Lazor³

et al. 2016

Semin Respir Crit Care Med

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As the bronchioles have a strategic position between the airways and the alveolar structures, they are at a site where disorders of many origins may develop, including infections, inflammatory and/or fibrosing processes of immune, occupational, environmental, tumoral, and iatrogenic origin, which may result in predominant bronchiolitis and/or organizing pneumonia. This etiologic variety results in many distinct entities and syndromes, common or rare, with new or renewed faces such as bronchiolocentric interstitial pneumonia or organizing pneumonia primed by radiation to the breast.

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Imaging of Small Airways and Emphysema

Cited by 10 publications

References 62 publications

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

Perspectives in veterinary medicine: Description and classification of bronchiolar disorders in cats

The computed tomographic “tree‐in‐bud” pattern: Characterization and comparison with radiographic and clinical findings in 36 cats

Many Faces of Bronchiolitis and Organizing Pneumonia

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