Respiratory Tract

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  • Created by: ACheng
  • Created on: 04-12-13 16:32

Bronchiectasis

  • local irreversible dilatation of bronchi
  • cause of haemoptysis, chronic sputum
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Causes of bronchiectasis

  • Bronchial obstruction
  • Bronchial wall damage
  • Parenchymal fibrosis

3 pathological subtypes

  • cylindrical - uniform airway dilatation
  • varicose - nonuniform
  • serpiginous
  • cystic
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Radiographic findings

  • thickened bronchial walls - single or tramlines
  • dilated bronchi can fill with mucous or pus - tubular, ovoid
  • cystic - multiple thin walled ring shadows with air fluid levels

HRCT

  • dilated bronchi +/- wall thickening
  • lack of tapering of bronchial lamina
  • signet ring sign (internal bronchial diameter greater than adjacent pulmonary artery
  • varicose - beaded appearance
  • cystic - string of cysts

Associated bronchiolitis

  • small centrilobular nodular and linear branching = tree in bud
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CT

MDCT with thin collimation currently technique of choice

Cystic fibrosis and ABPA - bilateral upper lobe distribution

TB - unilateral upper lobe

childhood viral - lower lobe distribution

CT not very good at diagnosing specific aetiologies of bronchiectasis.

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