Imaging of the patient with chronic bronchitis: an overview of old and new signs

Zompatori, Maurizio; Sverzellati, Nicola; Gentile, T.; Spaggiari, Lucia; Laporta, T.; Fecci, Luigi

doi:10.1007/s11547-006-0061-0

Cited by 16 publications

(7 citation statements)

References 24 publications

(51 reference statements)

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“…The quantitative evaluation of emphysema was obtained by visual score technique [22] modified by Zompatori et al [23]. The CT scan was performed using 140 kV, 200 mA, 1 s scanning time and 1.25 thickness, a window level between –500 and –700 Hounsfield unit, and a window width between 1,000 and 2,000 Hounsfield unit.…”

Section: Methodsmentioning

confidence: 99%

High-Resolution Computed Tomography Quantitation of Emphysema Is Correlated with Selected Lung Function Values in Stable COPD

D’Anna

Asnaghi

Caramori³

et al. 2011

Respiration

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Background: The literature shows conflicting results when high-resolution computed tomography (HRCT) scores of emphysema were correlated with different indices of airflow obstruction. Objectives: We correlated HRCT scores of emphysema with different indices of airflow obstruction. Methods: We performed HRCT of the chest in 59 patients, all smokers or ex-smokers, with stable chronic obstructive pulmonary disease of different severity [GOLD stages I–IV; mean age ± SD 67.8 ± 7.3 years; pack/years 51.0 ± 34.6; percent predicted forced expiratory volume in 1 s (FEV₁% predicted) 52.3 ± 17.6; post-bronchodilator FEV₁% predicted 56.5 ± 19.1; FEV₁/forced vital capacity (FVC) ratio 50.8 ± 10.2; post-bronchodilator FEV₁/FVC ratio 51.6 ± 11.0; percent diffusion lung capacity for carbon monoxide (DLCO%) 59.2 ± 21.1; DLCO/percent alveolar volume (VA%) 54.5 ± 18.2; percent residual volume 163.0 ± 35.6; percent total lung capacity (TLC%) 113.2 ± 15; residual volume/TLC 1.44 ± 0.2]. All patients were in stable phase. Results: The mean ± SD visual emphysema score in all patients was 25.6 ± 25.4%. There was a weak but significant correlation between the percentage of pulmonary emphysema and numbers of pack/years (R = +0.31, p = 0.024). The percentage of emphysema was inversely correlated with the FEV₁/FVC ratio before and after bronchodilator use (R = –0.44, p = 0.002, and R = –0.39, p = 0.005), DLCO% (R = –0.64, p = 0.0003) and DLCO/VA% (R = –0.68, p < 0.0001). A weak positive correlation was also found with TLC% (R = +0.28, p = 0.048). When patients with documented emphysema were considered separately, the best significant correlation observed was between DLCO/VA% and HRCT scan score (p = 0.007). Conclusions: These data suggest that in patients with stable chronic obstructive pulmonary disease of varying severity, the presence of pulmonary emphysema is best represented by the impaired gas exchange capability of the respiratory system.

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Section: Methodsmentioning

confidence: 99%

High-Resolution Computed Tomography Quantitation of Emphysema Is Correlated with Selected Lung Function Values in Stable COPD

D’Anna

Asnaghi

Caramori³

et al. 2011

Respiration

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“…Sometimes, multiple bronchial diverticula give rise on thinsection CT to an "accordion-like" appearance previously described in bronchographic studies [11]. However, there are only a few reports describing bronchial diverticula on thin-section CT [6,[10][11][12][13], and no data have been published on their relationship to clinical or other morphological features.…”

Section: Introductionmentioning

confidence: 98%

Bronchial diverticula in smokers on thin-section CT

Sverzellati

Ingegnoli

Calabrò³

et al. 2009

Eur Radiol

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The objective was to determine the prevalence of bronchial diverticula in smokers on thin-section CT and the relationship to clinical and other morphological features on CT. Thin-section CT images of 503 cigarette smokers were assessed for the profusion and location of diverticula in the major airways. The extent of the bronchial diverticula was recorded as follows: grade 0, none; grade 1, one to three diverticula; grade 2, more than three diverticula. The extent of emphysema, bronchial wall thickness, clinical features, and pulmonary function were compared in the sub-groups stratified according to the extent of bronchial diverticula. A total of 229/503 (45.5%) smokers had bronchial diverticula, with 168/503 (33.3%) and 61/503 (12.2%) having grade 1 and 2 bronchial diverticula respectively. Subjects with grade 2 bronchial diverticula were heavier smokers, reported a history of coughing more frequently, and showed more severe functional impairment, greater extent of emphysema and more severe bronchial wall thickening compared with subjects with grade 1 and those individuals without bronchial diverticula (P < 0.05). Multivariate regression analysis revealed that only bronchial wall thickness predicted the extent of the bronchial diverticula (P < 0.0001). Bronchial diverticula are a frequent finding in the major airways of smokers, and they are associated with other markers of smoking-related damage.

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“…Conditions determining an increase of intrabronchial pressure (such as cough) may promote the herniation through a weakened portion of bronchial wall [1].…”

Section: Discussionmentioning

confidence: 99%

“…Bronchial diverticula start as submicroscopic depressions and dilatations of the bronchial gland ducts on the mucosa surface, which coalesce and herniate through smooth-muscle cellular bundles [1]. They were first described in bronchoscopic and bronchographic studies [2] and afterwards detected on high resolution computed tomography, as isolated or multiple (accordion-like appearance) [3].…”

Section: Introductionmentioning

confidence: 99%

Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT

Ciccarese

Garzillo

Chiesa

et al. 2016

Monaldi Arch Chest Dis

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Bronchial diverticula have been described as a common radiological finding in smoker patients with COPD, but the specificity of this sign should be further investigated. Thus, the aim of our study was to evaluate the prevalence of diverticula in a cohort of non-smoker subjects.Between February and July 2012, 2438 patients were admitted to our Radiology Unit to undergo a chest CT. Among them, we enrolled 121 non-smoking patients (78/121-64.5% females, 43/121-35.5% males), of different age (57.0±20.7 years-range: 12-88), without any respiratory symptoms, submitted to chest CT for several reasons (oncologic evaluation: 59/121-48.8%; follow up of lung nodules: 27/121-22.3%; screening in connectivitis: 12/121-9.9%; others: 23/121-19.0%). We considered thin-section CT scan on axial, coronal and sagittal plans to evaluate prevalence, numbers and level of bronchial diverticula.Diverticula were found in 41/121-33.9% patients, with a slight major prevalence in males (p=0.048), but no significant difference on age. In 31/41-75.6% the number was <3, whereof 17/31-54.8% with just one diverticulum assessed. Regarding the level, in 30/41-73.2% they were subcarinal, but they were also detected in mainstem (2/41-4.9%) and lobar bronchi (with the right upper lobe bronchus most frequently involved -12/41-29.3%).Bronchial diverticula can be observed in non-smokers, as well as in smoker patients with COPD. However, their prevalence seems to be lower than in smokers and they tend to be isolated and subcarinal. The age of patients does not influence their finding. More studies should be proposed to better define a cut-off between smokers and healthy subjects. RiassuntoSebbene i diverticoli bronchiali rappresentino un reperto comune nei pazienti con BPCO, la specificità di questo segno dovrebbe essere ulteriormente indagata. Pertanto, l'oggetto del nostro studio è stata la valutazione della prevalenza dei diverticoli bronchiali in una popolazione di non fumatori.2438 pazienti sono stati sottoposti a TC torace presso il nostro Istituto tra Febbraio e Luglio 2012; tra questi, abbiamo selezionato 121 non fumatori (78/121-64.5% donne, 43/121-35.5% uomini), di diverse età (57.0±20.7 anni-range: 12-88), senza alcun sintomo respiratorio e con diverse indicazioni cliniche all'esecuzione dell'indagine (valutazione oncologica: 59/121-48.8%; follow-up di noduli polmonari: 27/121-22.3%; screening per connettivite: 12/121-9.9%; altro: 23/121:19.0%). La presenza, il numero e la sede dei diverticoli sono state valutate su immagini assiali TC a strato sottile.La presenza di diverticoli è stata registrata in 41/121-33.9% dei pazienti, con maggior prevalenza nei soggetti di sesso maschile (p=0.048), ma senza differenze in base all'età. In 31/41-75.6% casi il numero era <3, di cui singolo in 17/31-54.8%. Relativamente alla sede, la maggior parte (30/41-73.2%) dei diverticoli era sottocarenale, più rari a livello dei bronchi principali (2/41-4.9%) e lobari (con il bronco per il lobo superiore destro più frequentemente coinvolto -12/41-29.3%).I div...

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Imaging of the patient with chronic bronchitis: an overview of old and new signs

Cited by 16 publications

References 24 publications

High-Resolution Computed Tomography Quantitation of Emphysema Is Correlated with Selected Lung Function Values in Stable COPD

High-Resolution Computed Tomography Quantitation of Emphysema Is Correlated with Selected Lung Function Values in Stable COPD

Bronchial diverticula in smokers on thin-section CT

Incidental finding of bronchial diverticula in a non-smoker population: evaluation on thin-section CT

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