Thin-Section CT Detection of Emphysema Associated With Bronchiectasis and Correlation With Pulmonary Function Tests

Loubeyre, Pierre; Paret, Micheline; Revel, D.; Wiesendanger, T; Brune, J

doi:10.1378/chest.109.2.360

Cited by 57 publications

(32 citation statements)

References 29 publications

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“…Lack of reversibility of mosaic perfusion is not unexpected, as this CT feature is known to denote the histological finding of constrictive bronchiolitis [8], which does not respond to treatment in other contexts. The argument that mosaic perfusion in bronchiectasis might represent emphysema [23] is undermined by the lack of any relationship between the extent of mosaic perfusion and impairment of gas transfer [12]. In the present study, alterations in the extent of mosaic perfusion were not linked to variations in DL,CO or KCO levels.…”

Section: Discussioncontrasting

confidence: 64%

A comparison of serial computed tomography and functional change in bronchiectasis

Sheehan¹,

Wells²,

Copley³

et al. 2002

Eur Respir J

130

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In bronchiectasis the morphological determinants of (marginal) fluctuations in pulmonary function tests are uncertain. The aim of the present study was to evaluate serial computed tomography (CT) changes in relation to pulmonary function trends in patients with bronchiectasis.The relationships between pulmonary function indices and CT scans in 48 adult patients with bronchiectasis were evaluated at baseline and at follow-up, at a median interval of 28 months (range 6-74 months). Two independent observers semiquantitatively scored CT features of bronchial and small airways disease.At initial assessment, the severity of airflow obstruction was linked primarily to the extent of mosaic attenuation. However, serial changes in pulmonary function indices were only associated with serial changes in mucous plugging scores. Alterations in mucous plugging on serial CT were associated with changes in the severity of bronchiectasis and bronchial wall thickness. Greater severity of all three morphological abnormalities at baseline CT were predictive of significant declines in forced expiratory volume in one second, with severe bronchial wall thickness being the most adverse prognostic determinant.Variations in mucous plugging on computed tomography correlate with minor fluctuations in pulmonary function tests in bronchiectasis. However, the severity of bronchial wall thickness is the primary determinant of subsequent major functional decline. Eur Respir J 2002; 20: 581-587.

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Section: Discussioncontrasting

confidence: 64%

A comparison of serial computed tomography and functional change in bronchiectasis

Sheehan¹,

Wells²,

Copley³

et al. 2002

Eur Respir J

130

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“…We also found a negative correlation between HRCT score and FEV1%. This is in agreement with previous reports; as the HRCT score reflects bronchiolitis, areas of emphysema, bullae, and bronchiectatic segments [20]-all can affect FEV1% measurements [21].…”

supporting

confidence: 93%

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Hassan¹,

Ziada²,

El-hamd³

2014

OJRD

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Background: The combination of the clinical features, HRCT score and echocardiographic evidence of pulmonary hypertension help assess the prognosis in bronchiectasis. Aim: To test whether pulmonary and cardiac functions associated with bronchiectasis would differ according to its type (cystic versus cylindrical) utilizing HRCT score, PFTs and echocardiography. Patients and Methods: A cross-sectional study of patients with bronchiectasis was conducted at Chest and Internal Medicine Departments at Assiut University Hospital, Egypt. The diagnosis of bronchiectasis type was based on HRCT findings. PFTs, HRCT score and echocardiography were assessed in all cases. Results: We studied 56 patients with bronchiectasis; 31 were cystic (group A) and 25 were cylindrical (group B). Forced vital capacity (FVC%) and Dlco% were significantly lower in group A (P < 0.0001) as compared with group B; whereas FEF 25% -75% and FEV1 (0.04) were lower in group B. Global HRCT score, RVD and SPAP were significantly higher in group A (P = 0.002) and correlated with FEV1% (r = −0.51), and with SPAP (r = 0.16). Conclusions: Airway obstruction and small airway dysfunction were more significantly seen in cylindrical bronchiectasis. Patients with cystic bronchiectasis had significantly, higher global HRCT scores, RVD and SPAP. HRCT scores correlate with FEV 1% and SPAP and could be a predictor of future PH. Routine echocardiographic assessment of patients with bronchiectasis, particularly in those with cystic disease is highly recommended.

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“…In a study of patients with bronchiectasis, it was assumed that the widespread areas of decreased attenuation on HRCT were caused by emphysema, accounting for the functional gastrapping [99]. However, the "emphysema" seen in that study was not associated with decreased gas diffusing capacity, the functional hallmark of emphysema.…”

Section: Accuracy Of High-resolution Computed Tomography Signs and Inmentioning

confidence: 87%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

146

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Diseases affecting the small airways are difficult to detect by traditional diagnostic tests. Widespread involvement is needed before symptoms and abnormalities on pulmonary function testing or chest radiography become apparent. Obstruction of the bronchioles may be detected indirectly by computed tomography (CT) because regional under-ventilation results in reduced perfusion which in turn is shown as a mosaic attenuation pattern of the lung parenchyma. When there is inflammation of the bronchioles with accompanying exudate, the airways may become directly visible on CT, for example in cases of diffuse panbronchiolitis.Quantification of the various morphological features of small airways disease is possible from CT images and this increased precision has aided investigations of structure/function relationships.An understanding of the pathology and microscopic distribution of disease in relation to the airways allows some prediction of the likely computed tomography appearances in this wide spectrum of conditions, and thus helps to refine the differential diagnosis.

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Thin-Section CT Detection of Emphysema Associated With Bronchiectasis and Correlation With Pulmonary Function Tests

Cited by 57 publications

References 29 publications

A comparison of serial computed tomography and functional change in bronchiectasis

A comparison of serial computed tomography and functional change in bronchiectasis

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Small airways diseases: detection and insights with computed tomography

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