Imaging of small airways disease

Teel, Gordon S.; Engeler, Christopher E.; Tashijian, Joseph H.; duCret, Rene P.

doi:10.1148/radiographics.16.1.27

Cited by 54 publications

(24 citation statements)

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“…In addition to that, centrilobular air cysts were observed, thus suggesting underlying centrilobular emphysema. Centrilobular emphysema is commonly seen in the elderly and habitual smokers (8,9). An abnormality of the small airway function is also seen in smokers (10,11).…”

Section: Discussionmentioning

confidence: 99%

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

et al. 2010

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A 49-year-old female presented with diarrhea and a high fever followed by progressive dyspnea. Until this presentation, she had been healthy except for chronic dyspepsia and diarrhea. She had a smoking habit of 15 pack-years. Laboratory tests revealed lymphopenia, hypoalbuminemia and hypogammaglobulinemia. A rapid influenza test in combination with an RT-PCR assay revealed the presence of the novel influenza A (H1N1) virus. Chest computed tomography revealed centrilobular emphysema. This report suggests that regular smoking may become a risk for severe pneumonia in patients presenting with the novel influenza A (H1N1) virus, when accompanying asymptomatic emphysema is combined with other problems such as hypoalbuminemia and hypogammaglobulinemia.

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Section: Discussionmentioning

confidence: 99%

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

et al. 2010

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“…22,23,39 Hersh et al 34 found that gas trapping percentage, a prominent indirect sign of small airway disease, had a strong correlation with emphysema percentage and may fail to distinguish between gas trapping caused by emphysema and by small airway disease. 24,40 These authors described an index, the E/I MLA, using paired inspiratory and expiratory images, as a more reliable small airway disease measure in smokers. 34,41 We found a strong correlation between E/I MLA and all spirometric airflow obstruction indexes, including FEV 3 /FEV 6 (r ¼ À0.65) and FEV 3 % predicted (r ¼ À0.51).…”

Section: Spirometric Characterizationmentioning

confidence: 99%

A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria

Dilektaşlı

Pórszász

Casaburi

et al. 2016

Chest

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for the COPDGene investigators BACKGROUND: In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV 1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometric ratios, including the ratio of forced expiratory volume in 3 and 6 seconds (FEV 3 /FEV 6 ), and small airways measures and gas trapping at quantitative chest CT scanning, and clinical outcomes in the Genetic Epidemiology of COPD (COPDGene) cohort.

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“…Os achados da TCAR podem ser divididos em sinais diretos ou indiretos 42 . Os sinais diretos são o espessamento de parede e a obliteração dos bronquíolos, porém, são os achados menos comuns 43 .…”

Section: Tomografia De Tórax De Alta Resoluçãounclassified

“…Em cerca de 13 a 18% dos casos, as imagens obtidas em inspiração são normais, e a heterogeneidade de atenuação só é observada em expiração 46 . A identificação de aprisionamento aéreo nos cortes em expiração também pode ser útil para diferenciar as doenças das vias aéreas de outras causas de perfusão em mosaico 42 .…”

Section: Tomografia De Tórax De Alta Resoluçãounclassified

Post-infectious bronchiolitis obliterans in children

Champs

Lasmar²,

Camargos³

et al. 2011

J Pediatr (Rio J)

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Objective: To review publications about the main features of postinfectious bronchiolitis obliterans and its history, etiology, epidemiology, risk factors, pathogenesis, histological findings, clinical presentation, complementary tests, diagnostic criteria, differential diagnosis, treatment and prognosis.Sources: Non-systematic review of MEDLINE and LILACS databases and selection of 66 most relevant studies. Summary of the findings:In the post-infectious bronchiolitis obliterans there is an insult to respiratory epithelial cells, and its clinical severity is associated with the degree of lesion and inflammation. Diagnosis is made according to clinical signs and symptoms, by exclusion of main differential diagnoses and with the aid of complementary tests. High resolution CT, particularly images obtained during inspiration and expiration, provide information for the evaluation of the small airways. Pulmonary function tests show fixed airway obstructions and marked decrease of FEF 25-75% . Treatment has not been definitely established, and corticoids have been administered as pulse therapy or by inhalation of high doses of steroids. However, data about its efficacy are scarce in the literature. Long-term prognosis is variable, and there might be either clinical improvement or deterioration into respiratory insufficiency and death.Conclusion: Post-infectious bronchiolitis obliterans is a disease with a high morbidity rate; it should be treated by a multidisciplinary team, and patients should be followed up for a long period of time.J Pediatr (Rio J). 2011;87(3):187-198: Bronchiolitis obliterans, diagnosis, spirometry, CT, child. ResumoObjetivo: Revisar os trabalhos publicados sobre os principais aspectos da bronquiolite obliterante pós-infecciosa, relacionados com sua história, etiologia, epidemiologia, fatores de risco, patogenia, alterações histológicas, manifestações clínicas, exames complementares, critérios diagnósticos, diagnóstico diferencial, tratamento e prognóstico. Fonte dos dados:Realizou-se uma revisão não sistemática nas bases de dados MEDLINE e LILACS, selecionando-se 66 referências mais relevantes. Síntese dos dados:Na bronquiolite obliterante pós-infecciosa ocorre lesão do epitélio respiratório, e a gravidade clínica está relacionada aos diferentes graus de lesão e ao processo inflamatório. O diagnóstico baseia-se no quadro clínico, na exclusão dos principais diagnósticos diferenciais e no auxílio dos exames complementares. A tomografia computadorizada de alta resolução, principalmente com imagens em inspiração e expiração, possibilta a avaliação das pequenas vias aéreas. As provas de função pulmonar caracterizam-se por padrão obstrutivo fixo com redução acentuada do FEF 25-75% . O tratamento não está bem estabelecido, e o uso de corticoides tem sido preconizado em forma de pulsoterapia ou por via inalatória em elevadas doses, no entanto, os dados da literatura a respeito de sua eficácia ainda são escassos. O prognóstico a longo prazo é variável, podendo haver melhora clínica ou evolução par...

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Imaging of small airways disease

Cited by 54 publications

References 0 publications

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

Severe Pneumonia Caused by a Novel Influenza A (H1N1) Virus in an Asymptomatic Emphysematous Smoker

A Novel Spirometric Measure Identifies Mild COPD Unidentified by Standard Criteria

Post-infectious bronchiolitis obliterans in children

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