Role of HRCT in Evaluation of Bronchiectasis

Abstract

BACKGROUNDBronchiectasis is defined as a localised, irreversible dilatation of the bronchial tree. Bronchiectasis is a chronic and progressive lung disease and can lead to chronic respiratory failure. HRCT has emerged as the imaging modality of choice for evaluating suspected cases of bronchiectasis. HRCT is excellent in characterisation of the type of bronchiectasis and extent of lung involvement. AIMS 1. To study the role of HRCT in diagnosis of bronchiectasis. 2. To study regional distribution of bronchiectasis on HRCT. 3. To characterise bronchiectasis morphologically and to determine aetiologies of bronchiectasis wherever possible. MATERIAL AND METHODSA prospective study of 50 patients was done in the Department of Radiology and Imaging at Kakatiya Medical College and MGM General Hospital, Warangal. PATIENT SELECTIONPatients of all age groups were selected in whom clinically bronchiectasis was suspected. Ours was a random study for a period of three years and no specific criteria were laid down for patient selection. From May 2005 -April 2008, 50 patients clinically suspected to have bronchiectasis were subjected to chest radiograph and HRCT examination. RESULTSIn our study by co-relating HRCT findings and clinical history an accurate diagnosis was made in 46 cases, i.e. 76.6% which was confirmed by laboratory investigations. In our study 23 patients (46%) had pulmonary tuberculosis, in 8 patients (16%) no cause was found, 16 patients (32%) had history of recurrent childhood infections, 2 patients (4%) had bronchial asthma and COPD and 1 patient (2%) had allergic bronchopulmonary aspergillosis. In this study incidence was common in the age group of 21-30 years and is more common in males than females. Bilateral involvement is more common than unilateral involvement. CONCLUSIONIn a given clinical setting suggestive of bronchiectasis, HRCT serves as the best modality in confirming the diagnosis of bronchiectasis. HRCT is definitely superior to chest radiographs in the detection of bronchiectasis.