No abstract

No abstract

No abstract

No abstract

Bronchograms and plain chest radiographs of 27 patients with chronic sputum production were reported separately in random order and independently by two pulmonary radiologists to establish the diagnostic rate of each investigation and to assess interobserver variation.Both Two main groups of patients with bronchiectasis were identified by bronchography: 11 with bronchiectasis alone and eight with bronchiectasis and bronchographic features suggestive of "chronic bronchitis". There was no clinical difference between these two groups.Plain chest radiographs were insensitive, being diagnostic (both radiologists agreeing) of bronchiectasis in only nine of 19 (47%) patients with definite bronchiectasis on bronchography.Bronchiectasis is usually defined as irreversible dilatation of the bronchial tree. Reid described three different bronchographic appearances of bronchiectasis-namely, cylindrical, varicose, and saccular (cystic)-and related these to pathological changes in the bronchi.' In cylindrical bronchiectasis the bronchi have regular outlines, show no great increase in diameter, and usually end squarely and abruptly. Varicose bronchi show irregular dilatation and bulbous termination, while saccular bronchiectasis is characterised by bronchial dilatation that increases progressively towards the periphery of the lung, with a ballooned outline and few bronchial subdivisions.By contrast, in established chronic bronchitis (cough, sputum, and breathlessness for more than one year with some degree of disability without evidence of another cause)2 the principal bronchographic abnormalities are localised beaded bronchial dilatation, diverticulosis (mucus pits), poor peripheral filling of bronchi and bronchioles, peripheral pooling of contrast medium, and excessive vari-