Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens.

Kang, Eun Young; Miller, Russell L.; Müller, Néstor L.

doi:10.1148/radiology.195.3.7753989

Cited by 218 publications

(101 citation statements)

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“…No relationship was found between the clinical symptoms and disease progression on HRCT scan. This is in agreement with the fact that there is, to date, no satisfactory radiological scoring system for severity and progression of bronchiectasis [28].…”

Section: Discussionsupporting

confidence: 89%

Impaired pneumococcal antibody response in bronchiectasis of unknown aetiology

Kessel

Velzen‐Blad²,

Bosch³

et al. 2005

European Respiratory Journal

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As a defective anti-polysaccharide response can exist in the absence of an immunoglobulin deficiency, a series of 26 patients with bronchiectasis of unknown aetiology was vaccinated with a 23-valent pneumococcal polysaccharide vaccine. All patients suffered from recurrent respiratory tract infections.When measuring total antibody levels to pneumococcal serotypes 3, 4 and 9, a normal polysaccharide antibody response was found in 22 patients. However, only 11 of these subjects showed a normal pneumococcal antibody response within the IgA and/or IgG2 subclass, and thus could be classified as true responders, while 15 patients did not respond in either the IgA class or in the IgG2 subclass.When analysing differences between the responder (n511) and nonresponder (n515) groups, the latter demonstrated higher frequencies of respiratory tract infections and more severe lung pathology, as revealed by the presence of more bronchi visualised in the peripheral third of the lung by high-resolution computed tomography scanning. Moreover, nonresponders needed extensive lung surgery more often in order to control their disease (number of resected segments eight versus five).In conclusion, an important fraction of patients presenting with idiopathic bronchiectasis is associated with a selective anti-polysaccharide response deficiency and this subgroup appears to represent a more severe clinical phenotype. Therefore, it can be regarded as a separate clinical entity with possible therapeutic targets.In order to identify IgA and IgG2 anti-polysaccharide nonresponders, all patients presenting with bronchiectasis of unkown aetiology should be immunised with a pneumococcal polysaccharide vaccine, and IgA and IgG2 isotype responses should be evaluated as well as the total antibody response.

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Section: Discussionsupporting

confidence: 89%

Impaired pneumococcal antibody response in bronchiectasis of unknown aetiology

Kessel

Velzen‐Blad²,

Bosch³

et al. 2005

European Respiratory Journal

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“…Lynch et al showed that airflow obstruction was common in a majority of his study group (33 patients) [11]. The cause of airflow obstruction, most likely bronchiolitis, secretion, and bronchial hyper-responsiveness [12,13]. Hansel et al [14] studied areas of decreased attenuation using HRCT and concluded that small airway W. A. HASSAN ET AL.…”

Section: Discussionmentioning

confidence: 99%

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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“…It has a sensitivity of 96% and a specificity of 93% 13. Nevertheless, HRCT has some limitations, including respiratory and cardiac pulsation artefacts, false‐negative reports due to missed focal areas of bronchiectasis between section‐planes, and misinterpretation of bronchial‐artery ratio measurements 11. These limitations have been partially addressed using alternative CT modalities using different imaging algorithms.…”

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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Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens.

Abstract: Thin-section CT depicted bronchiectasis in most of the resected bronchiectatic lobes.

Cited by 218 publications

References 0 publications

Impaired pneumococcal antibody response in bronchiectasis of unknown aetiology

Impaired pneumococcal antibody response in bronchiectasis of unknown aetiology

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

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

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