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Mulette P, Perotin JM, Muggeo A, Guillard T, Brisebarre A, Meyer H, Hagenburg J, Ancel J, Dormoy V, Vuiblet V, Launois C, Lebargy F, Deslee G, Dury S. Bronchiectasis in renal transplant patients: a cross-sectional study. Eur J Med Res 2024; 29:120. [PMID: 38350996 PMCID: PMC10863148 DOI: 10.1186/s40001-024-01701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Bronchiectasis is a chronic airway disease characterized by permanent and irreversible abnormal dilatation of bronchi. Several studies have reported the development of bronchiectasis after renal transplantation (RT), but no prospective study specifically assessed bronchiectasis in this population. This study aimed to compare features of patients with bronchiectasis associated with RT to those with idiopathic bronchiectasis. METHODS Nineteen patients with bronchiectasis associated with RT (RT-B group) and 23 patients with idiopathic bronchiectasis (IB group) were prospectively included in this monocentric cross-sectional study. All patients underwent clinical, functional, laboratory, and CT scan assessments. Sputum was collected from 25 patients (n = 11 with RT-B and n = 14 with IB) and airway microbiota was analyzed using an extended microbiological culture. RESULTS Dyspnea (≥ 2 on mMRC scale), number of exacerbations, pulmonary function tests, total bronchiectasis score, severity and prognosis scores (FACED and E-FACED), and quality of life scores (SGRQ and MOS SF-36) were similar in the RT-B and IB groups. By contrast, chronic cough was less frequent in the RT-B group than in the IB group (68% vs. 96%, p = 0.03). The prevalence and diversity of the airway microbiota in sputum were similar in the two groups. CONCLUSION Clinical, functional, thoracic CT scan, and microbiological characteristics of bronchiectasis are overall similar in patients with IB and RT-B. These results highlight that in RT patients, chronic respiratory symptoms and/or airway infections should lead to consider the diagnosis of bronchiectasis. Further studies are required to better characterize the pathophysiology of RT-B including airway microbiota, its incidence, and impact on therapeutic management.
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Affiliation(s)
- Pauline Mulette
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France.
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Anaëlle Muggeo
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
- Laboratory of Bacteriology, Virology and Hygiene, Reims University Hospital, Reims, France
| | - Thomas Guillard
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
- Laboratory of Bacteriology, Virology and Hygiene, Reims University Hospital, Reims, France
| | - Audrey Brisebarre
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Hélène Meyer
- Department of Respiratory Diseases, Valenciennes Hospital Center, Valenciennes, France
| | - Jean Hagenburg
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Julien Ancel
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Valérian Dormoy
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Vincent Vuiblet
- Department of Nephrology and Renal Transplantation, Reims University Hospital, Reims, France
| | - Claire Launois
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - François Lebargy
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
| | - Gaëtan Deslee
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- Inserm UMR-S 1250, P3Cell, SFR CAP-Santé, University of Reims Champagne-Ardenne, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, Reims University Hospital, Maison Blanche University Hospital, 45, Rue de Cognacq-Jay, 51 092, Reims Cedex, France
- EA7509 IRMAIC, University of Reims Champagne-Ardenne, Reims, France
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Charon L, Launois C, Perotin JM, Ravoninjatovo B, Mulette P, Ancel J, Guillard T, Muggeo A, Dormoy V, Griffon M, Carré S, Lebargy F, Deslée G, Dury S. Current cough and sputum assessed by the cough and sputum assessment-questionnaire (CASA-Q) is associated with quality of life impairment in cystic fibrosis. BMC Pulm Med 2023; 23:457. [PMID: 37990322 PMCID: PMC10664648 DOI: 10.1186/s12890-023-02701-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/09/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Cough and sputum are major symptoms in cystic fibrosis (CF) that contribute to the impairment of quality of life. METHODS This prospective single centre cross-sectional pilot study aimed to evaluate the results of a self-administered questionnaire assessing cough and sputum symptoms (2 domains), and their impact (2 domains) on daily activities in the previous week, named the Cough and Sputum Assessment Questionnaire (CASA-Q) in CF adult patients at stable state, and to analyse associations with clinical, functional, microbiological, radiological data, and two quality of life scales: the Cystic Fibrosis Questionnaire Revised (CFQ-R) and the Saint George Respiratory Questionnaire (SGRQ). RESULTS Forty-eight patients were included in this analysis (69% men; median age of 27.8 ± 8.1 years; median body mass index of 21.8 + 3.3 kg/m²; mean FEV1 of 64 ± 30% of the predicted value). The mean values of the CASA-Q domains were 58 ± 23 for cough symptoms, 77 ± 24 for cough impact, 62 ± 25 for sputum symptoms and 84 ± 21 for sputum impact. Impairment in CASA-Q cough and sputum domains was associated with dyspnea mMRC scale (p < 0.005 for all 4 domains of CASA-Q) and exacerbations in the previous year (p < 0.05 for CASA-Q symptoms domains). We also found correlations between all domains of the CASA-Q and quality of life questionnaires including SGRQ (p < 0.001) and to a lesser extend CFQ-R. We identified a clinical phenotype (female gender, ΔF508 heterozygous mutation, dyspnea mMRC scale) associated with an impairment of CASA-Q score and quality of life using a 2-step cluster analysis. CONCLUSIONS CASA-Q allows the assessment of cough and sputum in CF adult patients and is associated with quality of life impairment. This simple easy-to-use tool could be used in routine clinical practice and in clinical studies to assess cough and sputum in CF patients. TRIAL REGISTRATION The study was registered on ClinicalTrials.gov (NCT02924818, first posted on 5th October 2016).
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Affiliation(s)
- Lucie Charon
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Claire Launois
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Jeanne-Marie Perotin
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Bruno Ravoninjatovo
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Pauline Mulette
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Julien Ancel
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Thomas Guillard
- Laboratoire de Bactériologie-Virologie-Hygiène hospitalière- Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, Reims, U 1250, France
| | - Anaëlle Muggeo
- Laboratoire de Bactériologie-Virologie-Hygiène hospitalière- Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, Reims, U 1250, France
| | - Valérian Dormoy
- INSERM UMRS 1250, Université de Reims Champagne-Ardenne, Reims, France
| | - Muriel Griffon
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - Sophie Carré
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France
| | - François Lebargy
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, EA7509 IRMAIC, CHU de Reims, Reims, France
| | - Gaëtan Deslée
- Service des Maladies Respiratoires et Allergiques, Université de Reims Champagne-Ardenne, INSERM, CHU de Reims, P3Cell, U 1250, Reims, France
| | - Sandra Dury
- Service des Maladies Respiratoires et Allergiques, CHU de Reims, Reims, France.
- EA7509 IRMAIC, Université de Reims Champagne-Ardenne, Reims, France.
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Murtha L, Sathiadoss P, Salameh JP, Mcinnes MDF, Revah G. Chest CT Findings in Marijuana Smokers. Radiology 2022; 307:e212611. [PMID: 36378033 DOI: 10.1148/radiol.212611] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Global consumption of marijuana is increasing, but there is a paucity of evidence concerning associated lung imaging findings. Purpose To use chest CT to investigate the effects of marijuana smoking in the lung. Materials and Methods This retrospective case-control study evaluated results of chest CT examinations (from October 2005 to July 2020) in marijuana smokers, nonsmoker control patients, and tobacco-only smokers. We compared rates of emphysema, airway changes, gynecomastia, and coronary artery calcification. Age- and sex-matched subgroups were created for comparison with tobacco-only smokers older than 50 years. Results were analyzed using χ2 tests. Results A total of 56 marijuana smokers (34 male; mean age, 49 years ± 14 [SD]), 57 nonsmoker control patients (32 male; mean age, 49 years ± 14), and 33 tobacco-only smokers (18 male; mean age, 60 years ± 6) were evaluated. Higher rates of emphysema were seen among marijuana smokers (42 of 56 [75%]) than nonsmokers (three of 57 [5%]) (P < .001) but not tobacco-only smokers (22 of 33 [67%]) (P = .40). Rates of bronchial thickening, bronchiectasis, and mucoid impaction were higher among marijuana smokers compared with the other groups (P < .001 to P = .04). Gynecomastia was more common in marijuana smokers (13 of 34 [38%]) than in control patients (five of 32 [16%]) (P = .039) and tobacco-only smokers (two of 18 [11%]) (P = .040). In age-matched subgroup analysis of 30 marijuana smokers (23 male), 29 nonsmoker control patients (17 male), and 33 tobacco-only smokers (18 male), rates of bronchial thickening, bronchiectasis, and mucoid impaction were again higher in the marijuana smokers than in the tobacco-only smokers (P < .001 to P = .006). Emphysema rates were higher in age-matched marijuana smokers (28 of 30 [93%]) than in tobacco-only smokers (22 of 33 [67%]) (P = .009). There was no difference in rate of coronary artery calcification between age-matched marijuana smokers (21 of 30 [70%]) and tobacco-only smokers (28 of 33 [85%]) (P = .16). Conclusion Airway inflammation and emphysema were more common in marijuana smokers than in nonsmokers and tobacco-only smokers, although variable interobserver agreement and concomitant cigarette smoking among the marijuana-smoking cohort limits our ability to draw strong conclusions. © RSNA, 2022 See also the editorial by Galvin and Franks in this issue.
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Affiliation(s)
- Luke Murtha
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Paul Sathiadoss
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Jean-Paul Salameh
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Matthew D. F. Mcinnes
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
| | - Giselle Revah
- From the Department of Radiology, Ottawa Hospital General Campus, 501 Smyth Rd, Ottawa, ON, Canada K1H 8L6
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Kim NY, Lee CH, Jin KN, Lee HW, Heo EY, Kim DK, Lee JK. Clinical Deterioration and Lung Function Change in Patients With Concomitant Asthma and Bronchiectasis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2607-2613.e4. [PMID: 35690367 DOI: 10.1016/j.jaip.2022.05.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 05/10/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Only limited data are available regarding the effects of bronchiectasis on the clinical course of asthma. OBJECTIVE This study evaluated longitudinal clinical outcomes according to bronchiectasis status in patients with asthma. METHODS This retrospective study included patients with asthma who underwent chest computed tomography and pulmonary function tests between January 2013 and December 2019. The annual incidence of episodes of moderate-to-severe acute clinical deterioration (exacerbations) and longitudinal changes in lung function were evaluated. RESULTS Of 667 patients with asthma, 251 had bronchiectasis. Patients with bronchiectasis had significantly more history of tuberculosis and nontuberculous mycobacterial lung disease, and lower forced expiratory volume in 1 second and forced vital capacity, compared with patients without bronchiectasis, although there was no difference in smoking intensity and inhaled corticosteroid treatment. Bronchiectasis was significantly associated with higher annual rates of severe and moderate-to-severe acute exacerbations; it was also associated with greater risk of acute exacerbation during follow-up. The severity and progression of bronchiectasis were independent risk factors for acute exacerbation. There were no significant differences in annual decline of lung function according to bronchiectasis status or bronchiectasis progression. CONCLUSIONS In patients with asthma, the presence and progression of bronchiectasis were significantly associated with increased risk of moderate-to-severe acute exacerbation, but they were not associated with longitudinal changes in lung function.
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Affiliation(s)
- Na Young Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Chang-Hoon Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Kwang Nam Jin
- Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Hyun Woo Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Eun Young Heo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Deog Kyeom Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jung-Kyu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
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Green O, Knee A, Patino A, Modahl L, Liautaud S. The effect of a training webinar on decreasing inter-observer variability in making a radiologic diagnosis of bronchiectasis. BMC Med Imaging 2022; 22:148. [PMID: 36002806 PMCID: PMC9399978 DOI: 10.1186/s12880-022-00878-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 08/17/2022] [Indexed: 11/29/2022] Open
Abstract
Non-cystic fibrosis bronchiectasis is a clinically important disease with an estimated 340,000–522,000 persons living with the disease and 70,000 being diagnosed annually. The radiographic diagnosis remains a pivotal part of recognizing the disease due to its protean clinical manifestations. As physicians are sensitized to this disease, a greater proportion of patients are being diagnosed with mild to moderate bronchiectasis. Despite the established use of CT chest as the main tool for making a radiologic diagnosis of bronchiectasis, the literature supporting the process of making that diagnosis is somewhat sparse. Concurrently, there has been an increased trend to have Web-based radiologic tutorials due to its convenience, the ability of the learner to set the pace of learning and the reduced cost compared to in-person learning. The COVID-19 pandemic has accelerated this trend. We wanted to look carefully at the effect of a Web-based training session on interrater reliability. Agreement was calculated as percentages and kappa and prevalence adjusted kappa calculated. We found that a single Web-based training session had little effect on the variability and accuracy of diagnosis of bronchiectasis. Larger studies are needed in this area with multiple training sessions.
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Affiliation(s)
- O'Neil Green
- UMASS-Baystate, 759 Chestnut St, Springfield, MA, 01144, USA.
| | - Alexander Knee
- Department of Healthcare Delivery and Population Science, Baystate Medical Center, 759 Chestnut St, Springfield, MA, 01144, USA
| | - Angelica Patino
- Department of Radiology, UMASS-Baystate, 759 Chestnut St, Springfield, MA, 01144, USA
| | - Lucy Modahl
- Department of Radiology, UMASS-Baystate, 759 Chestnut St, Springfield, MA, 01144, USA
| | - Sybille Liautaud
- Department of Pulmonary and Critical Care Medicine, UMASS-Baystate, 759 Chestnut St, Springfield, MA, 01144, USA
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Kim SH, Yang B, Yoo JY, Cho JY, Kang H, Shin YM, Kim EG, Lee KM, Choe KH. Clinical characteristics, radiological features, and disease severity of bronchiectasis according to the spirometric pattern. Sci Rep 2022; 12:13167. [PMID: 35915114 PMCID: PMC9343368 DOI: 10.1038/s41598-022-17085-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
Bronchiectasis show various ventilatory disorders in pulmonary function. The characteristics and severity of patients with bronchiectasis according to these pulmonary dysfunctions are still very limited. This study aimed to evaluate the clinical, radiologic feature and the disease severity of patients with bronchiectasis according to spirometric patterns. We retrospectively evaluated 506 patients with bronchiectasis who underwent pulmonary lung function test (PFT) at a referral hospital between 2014 to 2021. The results showed that cylindrical type was the most common (70.8%) type of bronchiectasis on chest Computed tomography (CT), and 70% of patients had bilateral lung involvement. On the other hand, obstructive ventilatory disorder was the most common (51.6%), followed by normal ventilation (30%) and restrictive ventilatory disorder (18.4%). The modified Medical Research Council (mMRC) was highest in patients with obstructive ventilatory disorders, Modified Reiff score [median (interquartile range)] [6 (3–10), P < 0.001], FACED (FEV1, Age, Chronic colonization, Extension, and Dyspnea) score [3 (1–4), P < 0.001], and Bronchiectasis Severity (BSI) score [8 (5–11), P < 0.001] showed significantly highest values of obstructive ventilatory disorder rather than restrictive ventilatory disorder and normal ventilation. More than half of patients with bronchiectasis had obstructive ventilatory disorder. Bronchiectasis with obstructive ventilatory disorders has more dyspnea symptom, more disease severity and more radiologic severity. There was no significant association between spirometric pattern and radiologic type, but the more severe the radiologic severity, the more severe the lung function impairment.
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Affiliation(s)
- Sun-Hyung Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Bumhee Yang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jin Young Yoo
- Department of Radiology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jun Yeun Cho
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hyeran Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Yoon Mi Shin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Eung-Gook Kim
- Department of Biochemistry, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ki Man Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kang Hyeon Choe
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
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Xu JF, Gao YH, Song YL, Qu JM, Guan WJ. Research advances and clinical management of bronchiectasis: Chinese perspective. ERJ Open Res 2022; 8:00017-2022. [PMID: 35415184 PMCID: PMC8995535 DOI: 10.1183/23120541.00017-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/22/2022] [Indexed: 11/20/2022] Open
Abstract
Bronchiectasis is a debilitating chronic suppurative airway disease that confers a substantial burden globally. Despite the notable prevalence, research on bronchiectasis in mainland China remains in its infancy. Nevertheless, there has been a significant leap in the quantity and quality of research, which has contributed to the ever-improving clinical practice. A nationwide collaborative platform has been established to foster multicentre studies, which will help increase the level of evidence further. Here, we summarise the status quo of clinical management and consider the research priorities for bronchiectasis that have been published previously. We also highlight the efforts of the Chinese medical communities to outline the core tasks that need to be addressed within the next decade. The remarkable progress made in bronchiectasis research has revolutionised clinical practice in mainland Chinahttps://bit.ly/3K8kQYr
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Tan C, Ma D, Wang K, Tu C, Chen M, Zheng X, Liang Y, Huang Y, Wang Z, Wu J, Huang J, Liu J. The Role of Impulse Oscillometry in Evaluating Disease Severity and Predicting the Airway Reversibility in Patients With Bronchiectasis. Front Med (Lausanne) 2022; 9:796809. [PMID: 36687424 PMCID: PMC9847491 DOI: 10.3389/fmed.2022.796809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 02/02/2022] [Indexed: 01/25/2023] Open
Abstract
Background Impulse oscillometry (IOS) can be used to evaluate airway impedance in patients with obstructive airway diseases. Previous studies have demonstrated that IOS parameters differ between patients with bronchiectasis and healthy controls. This study aims to explore the usefulness of IOS in assessing disease severity and airway reversibility in patients with bronchiectasis. Method Seventy-four patients with non-cystic fibrosis bronchiectasis who visited our Respiratory Medicine outpatient clinic were consecutively recruited. Spirometry, plethysmography and IOS tests were performed. Patients were stratified into mild, moderate and severe disease according to Reiff, Bhalla, BSI, FACED, and BRICS scores. Airway reversibility was measured by bronchodilation test (BDT) and the result was classified as positive or negative. ROC curves of IOS parameters were used to assess the usefulness of IOS parameters in predicting airway reversibility. Correlations between the IOS, spirometric lung function and bronchiectasis severity parameters were analyzed. Results Many IOS parameters, such as airway resistance at 5 Hz (R5), small airways resistance (R5-R20), total airway reactance (X5), resonance frequency (Fres), total airway impedance at 5 Hz (Z5), and peripheral resistance (Rp) increased in patients with bronchiectasis who presented a moderate to severe severity as categorized by the FACED, BSI and Reiff scores. Large airway resistance (R20) and central resistance (Rc) were not significantly different among groups with different bronchiectasis severity. The difference between R5 and R20 (R5-R20) showed 81.0% sensitivity, and 69.8%specificity in predicting the airway reversibility in bronchiectasis with AUC of 0.794 (95%CI, 0.672-0.915). Conclusion IOS measurements are useful indicators of bronchiectasis severity and may be useful for predicting the airway reversibility.
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Affiliation(s)
- Cuiyan Tan
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Donghai Ma
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Kongqiu Wang
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Changli Tu
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Meizhu Chen
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xiaobin Zheng
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yingjian Liang
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yiying Huang
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhenguo Wang
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jian Wu
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jin Huang
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jing Liu
- Department of Pulmonary and Critical Care Medicine, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,*Correspondence: Jing Liu
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Kuzniewski CT, Kizhner O, Donnelly EF, Henry TS, Amin AN, Kandathil A, Kelly AM, Laroia AT, Lee E, Martin MD, Morris MF, Raptis CA, Sirajuddin A, Wu CC, Kanne JP. ACR Appropriateness Criteria® Chronic Cough. J Am Coll Radiol 2021; 18:S305-S319. [PMID: 34794590 DOI: 10.1016/j.jacr.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/20/2022]
Abstract
Chronic cough is defined by a duration lasting at least 8 weeks. The most common causes of chronic cough include smoking-related lung disease, upper airway cough syndrome, asthma, gastroesophageal reflux disease, and nonasthmatic eosinophilic bronchitis. The etiology of chronic cough in some patients may be difficult to localize to an isolated source and is often multifactorial. The complex pathophysiology, clinical presentation, and variable manifestations of chronic cough underscore the challenges faced by clinicians in the evaluation and management of these patients. Imaging plays a role in the initial evaluation, although there is a lack of high-quality evidence guiding which modalities are useful and at what point in time the clinical evaluation should be performed. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Edwin F Donnelly
- Panel Chair and Chief, Thoracic Imaging, The Ohio State University Wexner Medical Center, Columbus, Ohio; and Co-Chair, Physics Module Committee, RSBA
| | - Travis S Henry
- Panel Vice-Chair, University of California San Francisco, San Francisco, California; Course Co-Director, HRCT Course, ACR Education Center, Reston Virginia; and Division Chief, Cardiothoracic Radiology, Duke University Hospital
| | - Alpesh N Amin
- University of California Irvine, Irvine, California; American College of Physicians
| | | | | | | | - Elizabeth Lee
- University of Michigan Health System, Ann Arbor, Michigan
| | - Maria D Martin
- Director of Diversity and Inclusion, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | | | | | - Carol C Wu
- Deputy Chair Ad Interim, The University of Texas MD Anderson Cancer Center, Houston, Texas; Chair, Society of Thoracic Radiology Big Data Committee; and Chair, Thoracic Use Cases Panel - ACR DSI
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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10
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Ebrahimian S, Digumarthy SR, Bizzo B, Primak A, Zimmermann M, Tarbiah MM, Kalra MK, Dreyer KJ. Artificial Intelligence has Similar Performance to Subjective Assessment of Emphysema Severity on Chest CT. Acad Radiol 2021; 29:1189-1195. [PMID: 34657812 DOI: 10.1016/j.acra.2021.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022]
Abstract
RATIONALE AND OBJECTIVES To compare an artificial intelligence (AI)-based prototype and subjective grading for predicting disease severity in patients with emphysema. METHODS Our IRB approved HIPAA-compliant study included 113 adults (71±8 years; 47 females, 66 males) who had both non-contrast chest CT and pulmonary function tests performed within a span of 2 months. The disease severity was classified based on the forced expiratory volume in 1 second (FEV1 as % of predicted) into mild, moderate, and severe. 2 thoracic radiologists (RA), blinded to the clinical and AI results, graded severity of emphysema on a 5-point scale suggested by the Fleischner Society for each lobe. The whole lung scores were derived from the summation of lobar scores. Thin-section CT images were processed with the AI-Rad Companion Chest prototype (Siemens Healthineers) to quantify low attenuation areas (LAA < - 950 HU) in whole lung and each lobe separately. Bronchial abnormality was assessed by both radiologists and a fully automated software (Philips Healthcare). RESULTS Both AI (AUC of 0.77; 95% CI: 0.68 - 0.85) and RA (AUC: 0.76, 95% CI: 0.65 - 0.84) emphysema quantification could differentiate mild, moderate, and severe disease based on FEV1. There was a strong positive correlation between AI and RA (r = 0.72 - 0.80; p <0.001). The combination of emphysema and bronchial abnormality quantification from radiologists' and AI assessment could differentiate between different severities with AUC of 0.80 - 0.82 and 0.87, respectively. CONCLUSION The assessed AI-prototypes can predict the disease severity in patients with emphysema with the same predictive value as the radiologists.
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11
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Impact of bronchial wall thickness on airflow obstruction in bronchiectasis. Respir Physiol Neurobiol 2021; 295:103788. [PMID: 34555525 DOI: 10.1016/j.resp.2021.103788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/19/2021] [Indexed: 11/23/2022]
Abstract
The association between airflow obstruction and bronchial dilation has been researched in bronchiectasis. However, the impact of bronchial wall thickening on airflow obstruction has not been thoroughly investigated. This study assessed the underlying mechanism of airflow obstruction in bronchiectasis due to abnormal bronchial wall thickening using oscillometry. A total of 98 patients with bronchiectasis were retrospectively reviewed. At the time of diagnosis, spirometric and oscillometric parameters, high-resolution computed tomography scores, and clinical characteristics were collected. The bronchial diameter, bronchial wall thickness, and extent of emphysema were evaluated semi-quantitatively. Correlations between patient data and characteristics were analyzed. Thirty-three patients with airflow obstruction showed higher respiratory resistance, more negative respiratory reactance (Xrs) at 5 Hz (X5), and higher bronchial wall thickness score than those without airflow obstruction. The bronchial wall thickness score negatively affected forced expiration volume in 1 s /forced vital capacity and X5. Abnormal bronchial wall thickening might make Xrs more negative and progress airflow obstruction in bronchiectasis.
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12
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Ledda RE, Balbi M, Milone F, Ciuni A, Silva M, Sverzellati N, Milanese G. Imaging in non-cystic fibrosis bronchiectasis and current limitations. BJR Open 2021; 3:20210026. [PMID: 34381953 PMCID: PMC8328081 DOI: 10.1259/bjro.20210026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/21/2023] Open
Abstract
Non-cystic fibrosis bronchiectasis represents a heterogenous spectrum of disorders characterised by an abnormal and permanent dilatation of the bronchial tree associated with respiratory symptoms. To date, diagnosis relies on computed tomography (CT) evidence of dilated airways. Nevertheless, definite radiological criteria and standardised CT protocols are still to be defined. Although largely used, current radiological scoring systems have shown substantial drawbacks, mostly failing to correlate morphological abnormalities with clinical and prognostic data. In limited cases, bronchiectasis morphology and distribution, along with associated CT features, enable radiologists to confidently suggest an underlying cause. Quantitative imaging analyses have shown a potential to overcome the limitations of the current radiological criteria, but their application is still limited to a research setting. In the present review, we discuss the role of imaging and its current limitations in non-cystic fibrosis bronchiectasis. The potential of automatic quantitative approaches and artificial intelligence in such a context will be also mentioned.
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Affiliation(s)
- Roberta Eufrasia Ledda
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Maurizio Balbi
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Francesca Milone
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Andrea Ciuni
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Mario Silva
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Nicola Sverzellati
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Gianluca Milanese
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
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13
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USE OF COMPUTED TOMOGRAPHY (CT) TO DETERMINE THE SENSITIVITY OF CLINICAL SIGNS AS A DIAGNOSTIC TOOL FOR RESPIRATORY DISEASE IN BORNEAN ORANGUTANS ( PONGO PYGMAEUS). J Zoo Wildl Med 2021; 52:470-478. [PMID: 34130389 DOI: 10.1638/2020-0128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 11/21/2022] Open
Abstract
Orangutans are noteworthy among great apes in their predilection for chronic, insidious, and ultimately fatal respiratory disease. Termed Orangutan Respiratory Disease Syndrome (ORDS), this cystic fibrosis-like disease is characterized by comorbid conditions of sinusitis, mastoiditis, airsacculitis, bronchiectasis, and recurrent pneumonia. The aim of this retrospective study was to determine the sensitivity of clinical signs in the diagnosis of ORDS in Bornean orangutans (Pongo pygmaeus) compared with the gold standard for diagnosis via computed tomography (CT). We retrospectively compared observed clinical signs with CT imaging in a population of clinically affected animals at an orangutan rescue center in southeastern Borneo. From August 2017 to 2019, this center housed 21 ORDS-affected animals, all of which underwent CT imaging to delineate which areas of the respiratory tract were affected. We reviewed clinical signs recorded in medical records and keeper observation notes for each individual for the period of 2 years prior to the date of the CT scan. A chi-square test of association was used to assess whether the observed clinical signs could predict the results of CT imaging. Results show that clinical signs may not be sensitive indicators in predicting respiratory disease identified by CT imaging. Based on the results of this study, clinical signs appear to be very poor predictors of underlying respiratory pathology in orangutans, based on high P-values, low sensitivity, and low specificity. This result is observed even with clinical signs data gathered over a full 24-mo period prior to CT scan performance. The findings of this study suggest the need for advanced imaging to properly diagnose and manage the most common health issue of captive orangutans.
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14
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Maselli DJ, Yen A, Wang W, Okajima Y, Dolliver WR, Mercugliano C, Anzueto A, Restrepo MI, Aksamit TR, Basavaraj A, Aliberti S, Young KA, Kinney GL, Wells JM, San José Estépar R, Lynch DA, Diaz AA. Small Airway Disease and Emphysema Are Associated with Future Exacerbations in Smokers with CT-derived Bronchiectasis and COPD: Results from the COPDGene Cohort. Radiology 2021; 300:706-714. [PMID: 34156303 DOI: 10.1148/radiol.2021204052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Chronic obstructive pulmonary disease (COPD) and bronchiectasis can overlap and share pathologic features, such as small airway disease (SAD). Whether the presence of SAD and emphysema in smokers with CT-derived bronchiectasis is associated with exacerbations is unknown. Purpose To assess whether SAD and emphysema in smokers with CT-derived bronchiectasis are associated with future exacerbations. Materials and Methods SAD and emphysema were quantified using the parametric response map method in former and current heavy smokers with and without bronchiectasis at CT from the COPDGene Study (from July 2009 to July 2018). Exacerbations were prospectively assessed through biannual follow-up. An exacerbation was defined as an increase in or new onset of respiratory symptoms treated with antibiotics and/or corticosteroids. Severe exacerbations were defined as those that required hospitalization. The association of a high burden of SAD (≥15.6%) and high burden of emphysema (≥5%) at CT with exacerbations was assessed with generalized linear mixed models. Results Of 737 participants, 387 (median age, 64 years [interquartile range, 58-71 years]; 223 women) had CT-derived bronchiectasis. During a 9-year follow-up, after adjustment for age, sex, race, body mass index, current smoking status, pack-years, exacerbations before study entry, forced expiratory volume in 1 second, or FEV1, and bronchiectasis severity CT score, high burden of SAD and high burden of emphysema were associated with a higher number of exacerbations per year (relative risk [RR], 1.89 [95% CI: 1.54, 2.33] and 1.37 [95% CI: 1.13, 1.66], respectively; P ≤ .001 for both). Results were comparable among participants with bronchiectasis meeting criteria for COPD (n = 197) (RR, 1.67 [95% CI: 1.23, 2.27] for high burden of SAD and 1.51 [95% CI: 1.20, 1.91] for high burden of emphysema; P ≤ .001 for both). Conclusion In smokers with CT-derived bronchiectasis and chronic obstructive pulmonary disease, structural damage to lung parenchyma and small airways was associated with a higher number of exacerbations per year. Clinical trial registration no. NCT00608764 © RSNA, 2021.
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Affiliation(s)
- Diego Jose Maselli
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Andrew Yen
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Wei Wang
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Yuka Okajima
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Wojciech R Dolliver
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Christina Mercugliano
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Antonio Anzueto
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Marcos I Restrepo
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Timothy R Aksamit
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Ashwin Basavaraj
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Stefano Aliberti
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Kendra A Young
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Gregory L Kinney
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - J Michael Wells
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Raúl San José Estépar
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - David A Lynch
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
| | - Alejandro A Diaz
- From the Division of Pulmonary Diseases and Critical Care, the University of Texas Health Science Center at San Antonio, San Antonio, Tex (D.J.M., A.A., M.I.R.); Department of Radiology, University of California, San Diego, Calif (A.Y.); Division of Sleep Medicine and Circadian Disorders (W.W.), Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.R.D., A.A.D.), and Department of Radiology (R.S.J.E.), Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; Department of Radiology, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan (Y.O.); Quinnipiac University School of Medicine, Hamden, Conn (C.M.); South Texas Veterans Health Care System, San Antonio, Tex (A.A., M.I.R.); Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minn (T.R.A.); Division of Pulmonary, Critical Care & Sleep Medicine, New York University School of Medicine, New York, NY (A.B.); Department of Pathophysiology and Transplantation, University of Milan Internal Medicine, and Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy (S.A.); Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colo (K.A.Y., G.L.K.); Division of Pulmonary, Allergy, and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Ala (J.M.W.); and Department of Radiology, National Jewish Health, Denver, Colo (D.A.L.)
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15
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Nursoy MA, Kilinc AA, Abdillahi FK, Ustabas Kahraman F, Al Shadfan LM, Sumbul B, Sennur Bilgin S, Cakir FB, Daskaya H, Cakir E. Relationships Between Bronchoscopy, Microbiology, and Radiology in Noncystic Fibrosis Bronchiectasis. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2021; 34:46-52. [PMID: 33989070 DOI: 10.1089/ped.2020.1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Published data on the correlations of bronchoscopy findings with microbiological, radiological, and pulmonary function test results in children with noncystic fibrosis (CF) bronchiectasis (BE) are unavailable. The aims of this study were to evaluate relationships between Bronchoscopic appearance and secretion scoring, microbiological growth, radiological severity level, and pulmonary function tests in patients with non-CF BE. Methods: Children with non-CF BE were identified and collected over a 6-year period. Their medical charts and radiologic and bronchoscopic notes were retrospectively reviewed. Results: The study population consisted of 54 female and 49 male patients with a mean age of 11.7 ± 3.4 years. In the classification according to the bronchoscopic secretion score, Grade I was found in 2, Grade II in 4, Grade III in 9, Grade IV in 17, Grade V in 25, and Grade VI in 46 patients. When evaluated according to the Bhalla scoring system, 45 patients had mild BE, 37 had moderate BE, and 21 had severe BE. Microbial growth was detected in bronchoalveolar lavage fluid from 50 of the patients. Forced expiratory volume in 1 s (FEV1) and functional vital capacity decreased with increasing bronchoscopic secretion grade (P = 0.048 and P = 0.04), respectively. The degree of radiological severity increased in parallel with the bronchoscopic secretion score (P = 0.007). However, no relationship was detected between microbiological growth rate and radiological findings (P = 0.403). Conclusions: This study showed that bronchoscopic evaluation and especially scoring of secretions correlate with severe clinical condition, decrease in pulmonary function test, worsening in radiology scores, and increase in microbiological bacterial load in patients. Flexible endoscopic bronchoscopy should be kept in mind in the initial evaluation of non-CF BE patients.
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Affiliation(s)
- Mustafa Atilla Nursoy
- Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Ayse Ayzit Kilinc
- Department of Pediatric Pulmonology, Istanbul Cerrahpasa University Medical Faculty, Istanbul, Turkey
| | | | | | | | - Bilge Sumbul
- Department of Microbiology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | | | - Fatma Betul Cakir
- Department of Pediatrics, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Hayrettin Daskaya
- Department of Anaesthesiology, and Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
| | - Erkan Cakir
- Department of Pediatric Pulmonolgy, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey
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16
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Woods JC, Wild JM, Wielpütz MO, Clancy JP, Hatabu H, Kauczor HU, van Beek EJ, Altes TA. Current state of the art MRI for the longitudinal assessment of cystic fibrosis. J Magn Reson Imaging 2020; 52:1306-1320. [PMID: 31846139 PMCID: PMC7297663 DOI: 10.1002/jmri.27030] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 12/02/2019] [Accepted: 12/02/2019] [Indexed: 12/13/2022] Open
Abstract
Pulmonary MRI can now provide high-resolution images that are sensitive to early disease and specific to inflammation in cystic fibrosis (CF) lung disease. With specificity and function limited via computed tomography (CT), there are significant advantages to MRI. Many of the modern MRI techniques can be performed throughout life, and can be employed to understand changes over time, in addition to quantification of treatment response. Proton density and T1 /T2 contrast images can be obtained within a single breath-hold, providing depiction of structural abnormalities and active inflammation. Modern radial and/or spiral ultrashort echo-time (UTE) techniques rival CT in resolution for depiction and quantification of structure, for both airway and parenchymal abnormalities. Contrast perfusion MRI techniques are now utilized routinely to visualize changes in pulmonary and bronchial circulation that routinely occur in CF lung disease, and noncontrast techniques are moving closer to clinical translation. Functional information can be obtained from noncontrast proton images alone, using techniques such as Fourier decomposition. Hyperpolarized-gas MRI, increasingly using 129 Xe, is now becoming more widespread and has been demonstrated to have high sensitivity to early airway obstruction in CF via ventilation MRI. The sensitivity of 129 Xe MRI promises future use in personalized medicine, management of early CF lung disease, and in future clinical trials. By combining structural and functional techniques, with or without hyperpolarized gases, regional structure-function relationships can be obtained, giving insight into the pathophysiology of disease and improved clinical management. This article reviews the modern MRI techniques that can routinely be employed for CF lung disease in nearly any large medical center. Level of Evidence: 4 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2019.
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Affiliation(s)
- Jason C. Woods
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children’s Hospital and University of Cincinnati; Cincinnati OH, USA
| | - Jim M. Wild
- Department of Radiology, University of Sheffield, Sheffield UK
| | - Mark O. Wielpütz
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC) Heidelberg, German Center for lung Research (DZL), Heidelberg, Germany
| | - John P. Clancy
- Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children’s Hospital and University of Cincinnati; Cincinnati OH, USA
| | - Hiroto Hatabu
- Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany
- Translational Lung Research Center (TLRC) Heidelberg, German Center for lung Research (DZL), Heidelberg, Germany
| | - Edwin J.R. van Beek
- Edinburgh Imaging, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Talissa A Altes
- Department of Radiology, University of Missouri, Columbia, MO, USA
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17
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Meerburg JJ, Veerman GDM, Aliberti S, Tiddens HAWM. Diagnosis and quantification of bronchiectasis using computed tomography or magnetic resonance imaging: A systematic review. Respir Med 2020; 170:105954. [PMID: 32843159 DOI: 10.1016/j.rmed.2020.105954] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Bronchiectasis is an irreversible dilatation of the airways caused by inflammation and infection. To diagnose bronchiectasis in clinical care and to use bronchiectasis as outcome parameter in clinical trials, a radiological definition with exact cut-off values along with image analysis methods to assess its severity are needed. The aim of this study was to review diagnostic criteria and quantification methods for bronchiectasis. METHODS A systematic literature search was performed using Embase, Medline Ovid, Web of Science, Cochrane and Google Scholar. English written, clinical studies that included bronchiectasis as outcome measure and used image quantification methods were selected. Criteria for bronchiectasis, quantification methods, patient demographics, and data on image acquisition were extracted. RESULTS We screened 4182 abstracts, selected 972 full texts, and included 122 studies. The most often used criterion for bronchiectasis was an inner airway-artery ratio ≥1.0 (42%), however no validation studies for this cut-off value were found. Importantly, studies showed that airway-artery ratios are influenced by age. To quantify bronchiectasis, 42 different scoring methods were described. CONCLUSION Different diagnostic criteria for bronchiectasis are being used, but no validation studies were found to support these criteria. To use bronchiectasis as outcome in future studies, validated and age-specific cut-off values are needed.
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Affiliation(s)
- Jennifer J Meerburg
- Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre -Sophia Children's Hospital, Wytemaweg 80, 3015CN, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Wytemaweg 80, 3015CN, Rotterdam, the Netherlands.
| | - G D Marijn Veerman
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus Medical Centre, Wytemaweg 80, 3015CN, Rotterdam, the Netherlands.
| | - Stefano Aliberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Adult Cystic Fibrosis Center, Dept of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Harm A W M Tiddens
- Department of Paediatric Pulmonology and Allergology, Erasmus Medical Centre -Sophia Children's Hospital, Wytemaweg 80, 3015CN, Rotterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Wytemaweg 80, 3015CN, Rotterdam, the Netherlands.
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18
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Chiu CC, Wang CJ, Lee WI, Wong KS, Chiu CY, Lai SH. Pulmonary function evaluation in pediatric patients with primary immunodeficiency complicated by bronchiectasis. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2020; 53:1014-1020. [PMID: 32094076 DOI: 10.1016/j.jmii.2020.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Primary immunodeficiency (PID) accompanying with recurrent respiratory infections is thought to have a devastating effect on lung function. However, the associations between the airway structural abnormalities on chest computed tomography (CT), severity of dyspnea, and deterioration of pulmonary function test (PFT) have not been fully addressed. METHODS Children diagnosed with PID in a tertiary referred center in northern Taiwan were enrolled. Demographic and clinical data including age, sex, age at diagnosis of PID, and follow-up period were collected. Chest CT images (modified Reiff scores), parameters of PFT, and life quality questionnaires (mMRC dyspnea scale) were analyzed and correlated using Spearman's rank correlation test. RESULTS A total of nineteen children with PID were enrolled and thirteen patients were diagnosed as having bronchiectasis based on chest CT scans. Modified Reiff scores of chest CT scan were negatively correlated with FEV1 (% predicted) and FEV1/FVC ratio (P < 0.05). A strongly negative correlation was found between the mMRC dyspnea scale and FEV1 (% predicted) and FVC (% predicted), but positively correlated with RV (% predicted) and RV/TLC ratio (P < 0.05). Furthermore, there was a negative correlation between FVC (% predicted) with increasing follow-up period (P < 0.05). CONCLUSIONS In pediatric patients with PID, chest CT scan appears to be a good tool for not only the diagnosis of bronchiectasis, but also the degree of pulmonary function impairment. Further quality of life impairments could be particularly due to the airflow obstruction and air trapping related to bronchiectasis.
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Affiliation(s)
- Chun-Che Chiu
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan
| | - Chao-Jan Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-I Lee
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kin-Sun Wong
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan
| | - Chih-Yung Chiu
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
| | - Shen-Hao Lai
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, and Chang Gung University, Taoyuan, Taiwan.
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19
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Abstract
Radiology plays a key role in the diagnosis of bronchiectasis, defined as permanent dilatation of the bronchial lumen. Volumetric thin-section multidetector computed tomography is an excellent noninvasive modality to evaluate bronchiectasis. Bronchiectasis is categorised by morphological appearance. Cylindrical bronchiectasis has a smooth tubular configuration and is the most common form. Varicose bronchiectasis has irregular contours with alternating dilating and contracting lumen. Cystic bronchiectasis is the most severe form and exhibits saccular dilatation of bronchi. Bronchial dilatation is the hallmark of bronchiectasis and is evaluated in relation to the accompanying pulmonary artery. A broncho–arterial ratio exceeding 1:1 should be considered abnormal. Normal bronchi are narrower in diameter the further they are from the lung hila. Lack of normal bronchial tapering over 2 cm in length, distal from an airway bifurcation, is the most sensitive sign of bronchiectasis. Findings commonly associated with bronchiectasis include bronchial wall thickening, mucus plugging and tree-in-bud opacities. Bronchiectasis results from a myriad of conditions, with post-infectious bronchiectasis being the most common. Imaging can sometimes discern the cause of bronchiectasis. However, in most cases it is nonspecific or only suggestive of aetiology. While morphological types are nonspecific, the distribution of abnormality offers clues to aetiology. Bronchiectasis is a chronic progressive condition with significant disease burden and frequent exacerbations for which the diagnosis relies on cross-sectional imaginghttp://bit.ly/2NxOLky
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Affiliation(s)
- Gunnar Juliusson
- Dept of Radiology, Landspitali University Hospital, Reykjavik, Iceland
| | - Gunnar Gudmundsson
- Dept of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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20
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Ghany MFA. Transthoracic ultrasound in the diagnosis of bronchiectasis: is it valuable? THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2019. [DOI: 10.4103/ejb.ejb_2_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Başaran AE, Başaran A, Maslak İC, Arslan G, Bingöl A. Evaluation of Noncystic Fibrosis Bronchiectasis Using Clinical and Radiological Scorings in Children. Turk Thorac J 2018; 19:159-164. [PMID: 30322443 DOI: 10.5152/turkthoracj.2018.17081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/20/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate radiological, clinical, and demographic data of patients with noncystic fibrosis bronchiectasis and to compare high-resolution computed tomography (HRCT) scores based on the demographic and clinical characteristics. MATERIALS AND METHODS A total of 34 patients (18 male, 16 female) were assessed in terms of age at symptom onset, age at diagnosis, annual attack frequency, cough severity score, physical examination findings, and pulmonary function test results. Modified Bhalla scoring system (B total) and anatomical prevalence degree score (D total) were used for HRCT examination. RESULTS There was a strong negative correlation between forced expiratory volume at first second (FEV1) and bronchial dilatation degree (SBRDIL). There was a moderate negative correlation of FEV1, forced vital capacity (FVC), and maximum mid-expiratory flow rate (MEF; 25-75) with bronchiectasis degree (EXBRNC), bronchial wall thickness degree (SBWTHICK), and mucus accumulation in the major airways (PMPLA). The B total, D total, EXBRNC, and SBRDIL scores were significantly higher in patients with hemoptysis and sputum. In comparing B and D total scoring systems, B total provided better results in terms of rale, annual exacerbation frequency (AEF), cough severity score (CSS), and FEV1 values. CONCLUSION As it is proved using HRCT, pulmonary function impairment, sputum production, hemoptysis, and increase in AEF strongly correlating with objective HRCT scoring can be accepted as markers for pathological changes due to bronchiectasis.
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Affiliation(s)
| | - Ayşen Başaran
- Department of Pediatrics, Akdeniz University School of Medicine, Antalya, Turkey
| | - İbrahim Cemal Maslak
- Division of Pediatric Allergy Immunology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Gökhan Arslan
- Department of Radiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ayşen Bingöl
- Division of Pediatric Pulmonology, Akdeniz University School of Medicine, Antalya, Turkey
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22
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Hung CT, Li SF, Chung WS. Increased risk of acute coronary syndrome in patients with bronchiectasis: A population-based cohort study. Respirology 2018; 23:828-834. [PMID: 29641845 DOI: 10.1111/resp.13298] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 02/16/2018] [Accepted: 02/26/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVE There are few studies on the relationship between bronchiectasis and acute coronary syndrome (ACS). We conducted a population-based cohort study to assess whether bronchiectasis was associated with an increased risk of ACS. METHODS We identified 3521 patients diagnosed with bronchiectasis between 2000 and 2010 (bronchiectasis cohort) and frequency matched them with 14 084 randomly selected people without bronchiectasis from the general population (comparison cohort) according to sex, age and index year using the Longitudinal Health Insurance Database. Both cohorts were followed until the end of 2010 to determine the ACS incidence. Hazard ratios of ACS were measured. RESULTS Based on 17 340 person-years for bronchiectasis patients and 73 639 person-years for individuals without bronchiectasis, the overall ACS risk was 40% higher in the bronchiectasis cohort (adjusted hazard ratio (HR) = 1.40; 95% CI: 1.20-1.62). Compared with those in the comparison cohort with one respiratory infection-related emergency room (ER) visit per year, the ACS risk was 5.46-fold greater in bronchiectasis patients with three or more ER visits per year (adjusted HR = 5.46, 95% CI: 4.29-6.96). Patients with bronchiectasis and three or more respiratory infection-related hospitalizations per year had an 8.15-fold higher ACS risk (adjusted HR = 8.15, 95% CI: 6.27-10.61). CONCLUSION Bronchiectasis patients, particularly those experiencing frequent exacerbations with three or more ER visits and consequent hospitalization per year, are at an increased ACS risk.
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Affiliation(s)
- Chin-Tun Hung
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Shu-Fen Li
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Wei-Sheng Chung
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
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23
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Dettmer S, Ringshausen F, Vogel-Claussen J, Fuge J, Faschkami A, Shin HO, Schwerk N, Welte T, Wacker F, Rademacher J. Computed tomography in adult patients with primary ciliary dyskinesia: Typical imaging findings. PLoS One 2018; 13:e0191457. [PMID: 29408869 PMCID: PMC5800555 DOI: 10.1371/journal.pone.0191457] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 01/07/2018] [Indexed: 12/15/2022] Open
Abstract
Objectives Among patients with non-cystic fibrosis bronchiectasis, 1–18% have an underlying diagnosis of primary ciliary dyskinesia (PCD) and it is suspected that there is under-recognition of this disease. Our intention was to evaluate the specific features of PCD seen on computed tomography (CT) in the cohort of bronchiectasis in order to facilitate the diagnosis. Materials and methods One hundred and twenty-one CTs performed in patients with bronchiectasis were scored for the involvement, type, and lobar distribution of bronchiectasis, bronchial dilatation, and bronchial wall thickening. Later, associated findings such as mucus plugging, tree in bud, consolidations, ground glass opacities, interlobular thickening, intralobular lines, situs inversus, emphysema, mosaic attenuation, and atelectasis were registered. Patients with PCD (n = 46) were compared to patients with other underlying diseases (n = 75). Results In patients with PCD, the extent and severity of the bronchiectasis and bronchial wall thickness were significantly lower in the upper lung lobes (p<0.001-p = 0.011). The lobar distribution differed significantly with a predominance in the middle and lower lobes in patients with PCD (<0.001). Significantly more common in patients with PCD were mucous plugging (p = 0.001), tree in bud (p <0.001), atelectasis (p = 0.009), and a history of resection of a middle or lower lobe (p = 0.047). Less common were emphysematous (p = 0.003) and fibrotic (p<0.001) changes. A situs inversus (Kartagener’s Syndrome) was only seen in patients with PCD (17%, p <0.001). Conclusion Typical imaging features in PCD include a predominance of bronchiectasis in the middle and lower lobes, severe tree in bud pattern, mucous plugging, and atelectasis. These findings may help practitioners to identify patients with bronchiectasis in whom further work-up for PCD is called for.
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Affiliation(s)
- Sabine Dettmer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Felix Ringshausen
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jens Vogel-Claussen
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Amir Faschkami
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Hoen-oh Shin
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Nicolaus Schwerk
- Department of Pediatric Pneumology and Neonatology, Hannover Medical School, Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Frank Wacker
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), Hannover, Germany
| | - Jessica Rademacher
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
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Hsieh MH, Fang YF, Chung FT, Lee CS, Chang YC, Liu YZ, Wu CH, Lin HC. Distance-saturation product of the 6-minute walk test predicts mortality of patients with non-cystic fibrosis bronchiectasis. J Thorac Dis 2017; 9:3168-3176. [PMID: 29221293 DOI: 10.21037/jtd.2017.08.53] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Previous surveillance methods to monitor the prognoses of patients with bronchiectasis are too complex for use in daily practice. The 6-minute walk test (6MWT) is a simple exercise test to predict the prognosis of chronic obstructive airway disease and numerous chronic lung diseases, including idiopathic pulmonary fibrosis. No studies have investigated exercise-induced oxygen desaturation (EID) and distance-saturation product (DSP) of 6MWT to predict the prognoses of patients with bronchiectasis. Methods This was a prospective study to identify correlations between variables of 6MWT and mortality in patients with bronchiectasis over a 6-year period. The study cohort included 69 patients with stable non-cystic fibrosis (non-CF) bronchiectasis who were regularly evaluated for functional status via 6-minute walk distance (6MWD), spirometry, BODE index, EID, and DSP. Results Of the 69 patients, 9 (13%) died and 60 (87%) survived during the 6-year follow-up period. The percentage of EID was higher [7 of 9 patients (78%) vs. 22 of 60 patients (27%), P=0.003] in the non-survivors group. The 6MWD (467.9±77.1 vs. 363.7±126.7 m, P=0.001) was higher in the survivors group. DSP was significantly lower in the non-survivors group (411.0±78.4 vs. 283.9±90.0 m%, P<0.001). Multivariate analysis showed that DSP (OR =0.983; 95% CI: 0.974-0.993, P=0.001) was the best parameter of 6MWT to predict mortality. Patients with a lower DSP of <280 m% were at a 66.5-fold greater risk (OR =66.5; 95% CI: 9.4-469.2) of 6-year mortality compared with those with DSP >280 m% (P<0.001). Conclusions DSP is a simple parameter to predict 6-year mortality in patients with non-CF bronchiectasis.
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Affiliation(s)
- Meng-Heng Hsieh
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yueh-Fu Fang
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Fu-Tsai Chung
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chung-Shu Lee
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yu-Chen Chang
- Department of Nuclear Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yuan-Zhang Liu
- Department of Radiology, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Cheng-Hsien Wu
- Department of Radiology, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Horng-Chyuan Lin
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Chang Gung University, College of Medicine, Taoyuan, Taiwan
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Tseng HJ, Henry TS, Veeraraghavan S, Mittal PK, Little BP. Pulmonary Function Tests for the Radiologist. Radiographics 2017; 37:1037-1058. [DOI: 10.1148/rg.2017160174] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Hsiang-Jer Tseng
- From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California–San Francisco, San Francisco, Calif (T.S.H.)
| | - Travis S. Henry
- From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California–San Francisco, San Francisco, Calif (T.S.H.)
| | - Srihari Veeraraghavan
- From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California–San Francisco, San Francisco, Calif (T.S.H.)
| | - Pardeep K. Mittal
- From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California–San Francisco, San Francisco, Calif (T.S.H.)
| | - Brent P. Little
- From the Department of Radiology and Imaging Sciences (H.J.T., P.K.M., B.P.L.) and Department of Medicine (S.V.), Emory University, 1364 Clifton Rd NE, Suite D125A, Atlanta, GA 30322; and Department of Radiology and Biomedical Imaging, University of California–San Francisco, San Francisco, Calif (T.S.H.)
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Al-Jahdali H, Alshimemeri A, Mobeireek A, Albanna AS, Al Shirawi NN, Wali S, Alkattan K, Alrajhi AA, Mobaireek K, Alorainy HS, Al-Hajjaj MS, Chang AB, Aliberti S. The Saudi Thoracic Society guidelines for diagnosis and management of noncystic fibrosis bronchiectasis. Ann Thorac Med 2017; 12:135-161. [PMID: 28808486 PMCID: PMC5541962 DOI: 10.4103/atm.atm_171_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 12/14/2022] Open
Abstract
This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources. We aim to provide clinicians with tools to standardize the diagnosis and management of bronchiectasis. This guideline targets primary care physicians, family medicine practitioners, practicing internists and respiratory physicians, and all other health-care providers involved in the care of the patients with bronchiectasis.
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Affiliation(s)
- Hamdan Al-Jahdali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Department of Medicine, Pulmonary Division, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alshimemeri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Department of Medicine, Pulmonary Division, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdullah Mobeireek
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- King Faisal Specialist Hospital and Research Centre, Department of Medicine, Pulmonary Division, Riyadh, Saudi Arabia
| | - Amr S. Albanna
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Department of Medicine, Pulmonary Division, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | | | - Siraj Wali
- College of Medicine, King Abdulaziz University, Respiratory Unit, Department of Medicine, Jeddah, Saudi Arabia
| | - Khaled Alkattan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Abdulrahman A. Alrajhi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
- King Faisal Specialist Hospital and Research Centre, Department of Medicine, Infectious Disease Division, Riyadh, Saudi Arabia
| | - Khalid Mobaireek
- College of Medicine, King Saud University, King Khalid University Hospital, Pediatric Pulmonology Division, Riyadh, Saudi Arabia
| | - Hassan S. Alorainy
- King Faisal Specialist Hospital and Research Centre, Respiratory Therapy Services, Riyadh, Saudi Arabia
| | - Mohamed S. Al-Hajjaj
- Department of Clinical Sciences, College of Medicine. University of Sharjah, Sharjah, UAE
| | - Anne B. Chang
- International Reviewer, Children's Centre of Health Research Queensland University of Technology, Queensland
- International Reviewer, Brisbane and Child Health Division, Menzies School of Health Research, Darwin, Australia
| | - Stefano Aliberti
- International Reviewer, Department of Pathophysiology and Transplantation, University of MilanInternal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center. Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Via Francesco Sforza 35, 20122, Milan, Italy
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Dai J, Zhu X, Bian D, Fei K, Jiang G, Zhang P. Surgery for predominant lesion in nonlocalized bronchiectasis. J Thorac Cardiovasc Surg 2016; 153:979-985.e1. [PMID: 28073573 DOI: 10.1016/j.jtcvs.2016.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 11/18/2016] [Accepted: 12/06/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Patients with nonlocalized bronchiectasis are encountered commonly; however, there is little information regarding surgical intervention in this patient population. The aim of this study was to evaluate symptomatic response and safety of anatomic resection of the predominant lesion via the use of lobectomy for the management of nonlocalized bronchiectasis. METHODS We reviewed the medical records of 37 consecutive patients who underwent lobectomy via thoracotomy for nonlocalized bronchiectasis between 2010 and 2013. The main surgical indications were nonlocalized bronchiectasis with one predominant lesion, failure of medical treatment, and adequate cardiopulmonary reserve. The predominant lesion was determined by preoperative computed tomography and/or bronchoscopy. Preoperative symptoms were compared with postoperative symptoms and analyzed by the use of paired techniques. RESULTS The mean patient age was 54.5 ± 6.4 years. There was no operative mortality. Postoperative complications occurred in 8 (21.6%) patients, including 1 with empyema, 1 with persistent air leak, and 6 with minor transient complications, all of which were manageable without any reoperation. After lobectomy, the median extent of residual bronchiectatic areas in the remaining lungs was 25% (range, 12.5%-42.9%). The frequency of acute infection (5.3 ± 2.1/year vs 1.8 ± 2.3/year) and hemoptysis (4.9 ± 2.8/year vs 1.1 ± 0.7/year) decreased significantly and the amount of sputum also decreased (37.1 ± 3.4 mL/day vs 10.7 ± 4.6 mL/day). Twenty-three (62.2%) patients were asymptomatic after surgery, 10 (27.0%) were symptomatic with clinical improvement, and 4 (10.8%) had no change or worsened. CONCLUSIONS Lobectomy for the predominant lesion is a safe procedure in the surgical treatment of nonlocalized bronchiectasis and leads to significant relief of symptoms with good rates of satisfaction.
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Affiliation(s)
- Jie Dai
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China
| | - Xinsheng Zhu
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China
| | - Dongliang Bian
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China
| | - Ke Fei
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China
| | - Gening Jiang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China
| | - Peng Zhang
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital Tongji University, Shanghai, People's Republic of China.
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Wang D, Luo J, Du W, Zhang LL, He LX, Liu CT. A morphologic study of the airway structure abnormalities in patients with asthma by high-resolution computed tomography. J Thorac Dis 2016; 8:2697-2708. [PMID: 27867544 DOI: 10.21037/jtd.2016.09.36] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Airway structure changes, termed as airway remodeling, are common in asthma patients due to chronic inflammation, which can be assessed by high-resolution computed tomography (HRCT). Considering the controversial conclusions in the correlation of morphologic abnormalities with clinical feature and outcome, we aimed to further specify and evaluate the structural abnormalities of Chinese asthmatics by HRCT. METHODS From August 2012 to February 2015, outpatients with asthma were recruited consecutively in the Asthma Center of West China Hospital, Sichuan University. Standard HRCT and pulmonary function test (PFT) were performed to collect information of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, atelectasis, and spirometric parameters. We reported the incidence of each structural abnormality in HRCT and compared it among different asthmatic severities. RESULTS A total of 123 asthmatics were enrolled, among which 84 (68.3%) were female and 39 (31.7%) were male. At least one structural abnormality was detected by HRCT in 85.4% asthmatics, and the incidence of bronchial wall thickening, bronchial dilatation, mucus impaction, emphysema, mosaic perfusion, and atelectasis was 57.7%, 51.2%, 22%, 24.4%, 5.7% and 1.6%, respectively. The incidences of bronchial wall thickening, bronchial dilation and emphysema were significantly increased by asthma severity (P<0.05), while incidences of mucus impaction (26/27, 96.30%), mosaic perfusion (6/7, 85.71%) and atelectasis (2/2, 100%) were mainly found in severe asthma. We found a longer asthma history (28.13±18.55 years, P<0.001, P=0.003), older age (51.30±10.70 years, P=0.022, P=0.006) and lower predicted percentage of forced expiratory volume in one second (FEV1%) (41.97±15.19, P<0.001, P<0.001) and ratio of forced expiratory volume to forced vital capacity (FEV1/FVC) (48.01±9.55, P<0.001, P<0.001) in patients with severe bronchial dilation compared with those in none and mild bronchial dilation. A negative correlation was also found between the extent of bronchial dilation and FEV1% as well as FEV1/FVC (r=-0.359, P=0.004; r=-0.266, P=0.035, respectively). CONCLUSIONS The incidences of structural abnormalities detected by HRCT are fairly high in Chinese asthma populations, especially the bronchial wall thickening and bronchial dilation, which are significantly increased in severe asthma, and are potential risk factors of pulmonary function decline in asthmatics.
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Affiliation(s)
- Dan Wang
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jian Luo
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
| | - Wen Du
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
| | - Lan-Lan Zhang
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
| | - Li-Xiu He
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
| | - Chun-Tao Liu
- Department of Respiratory and Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, Chengdu 610041, China
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Buscot M, Pottier H, Marquette CH, Leroy S. Phenotyping Adults with Non-Cystic Fibrosis Bronchiectasis: A 10-Year Cohort Study in a French Regional University Hospital Center. Respiration 2016; 92:1-8. [PMID: 27336790 DOI: 10.1159/000446923] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 05/09/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Data concerning phenotypes in bronchiectasis are scarce. OBJECTIVE The aim of this study was to describe the clinical, functional and microbiological phenotypes of patients with bronchiectasis. METHODS A monocentric retrospective study in a university hospital in France was conducted over 10 years (2002-2012). Non-cystic fibrosis patients with tomographic confirmation of bronchiectasis were included. The clinical, functional and microbiological data of patients were analyzed relying on the underlying etiology. RESULTS Of the 311 included patients, an etiology was found for 245 of them. At the time of diagnosis, the median age was 61 years and the mean FEV1 was 63% of predicted. The main causes of bronchiectasis were post-infectious (50%, mostly related to tuberculosis), chronic obstructive pulmonary disease (COPD; 13%) and idiopathic (11%). Other causes were immune deficiency (6%), asthma (4%), autoimmunity (3%), tumor (2%) and other causes (4%). The comparison of phenotypic traits shows significant differences between COPD, congenital and idiopathic groups in term of sex (p = 0.0175), tobacco status (p < 0.0001), FEV1 (p = 0.0412) and age at diagnosis (p < 0.001), Pseudomonas aeruginosa (PA) colonization (p = 0.0276) and lobectomy (0.0093). Functional follow-up was available in 30% of patients with a median duration of 2.7 years. Presence of PA was associated with a lower median FEV1 at diagnosis (43% p < 0.003) but not with a faster rate of decline in FEV1. CONCLUSION Distinctive clinical, functional and microbiological features were found for idiopathic, congenital and COPD-related bronchiectasis. A prospective follow-up of these subgroups is necessary to validate their relevance in the management of bacterial colonization and specific complications of these bronchiectases.
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Affiliation(s)
- Matthieu Buscot
- Service de Pneumologie, Centre Hospitalier Universitaire de Nice, Nice, France
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Correlation between a proposed MDCT severity score of bronchiectasis and pulmonary function tests. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2016. [DOI: 10.1016/j.ejrnm.2016.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Computed tomography of pulmonary changes in rheumatoid arthritis: carcinoembryonic antigen (CEA) as a marker of airway disease. Rheumatol Int 2016; 36:531-9. [PMID: 26886389 DOI: 10.1007/s00296-016-3438-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/02/2016] [Indexed: 12/14/2022]
Abstract
Rheumatoid arthritis (RA) classically affects the joints, but can present extra-articular manifestations, including pulmonary disease. The present study aimed to identify possible risk factors or laboratory markers for lung involvement in RA, particularly the presence of rheumatoid factor (RF), anti-citrullinated peptide antibodies (ACPA), and tumor markers, by correlating them with changes observed on chest high-resolution computerized tomography (HRCT). This cross-sectional study involved RA patients who were examined and questioned by a specialist physician and later subjected to chest HRCT and blood collection for measurement of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), ACPA (anti-vimentin and/or anti-CCP3), and the tumor markers carcinoembryonic antigen (CEA), CA 125, CA 15-3, and CA 19-9. A total of 96 patients underwent chest HRCT. The most frequent findings were bronchial thickening (27/28.1 %) and bronchiectasis (25/26 %). RF was present in 63.2 % of patients (55/87), and ACPA (anti-vimentin or anti-CCP3) was present in 72.7 % of patients (64/88). CEA levels were high in 14 non-smokers (37.8 %) and 23 smokers (62.2 %). CA-19-9 levels were high in 6 of 86 patients (7.0 %), CA 15-3 levels were high in 3 of 85 patients (3.5 %), and CA 125 levels were high in 4 of 75 patients (5.3 %). Multivariate analysis indicated a statistically significant association between high CEA levels and the presence of airway changes in patients with RA (p = 0.048). CEA can serve as a predictor of lung disease in RA and can help identify individuals who require more detailed examination for the presence of respiratory disorders.
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Scaglione M, Linsenmaier U, Schueller G, Berger F, Wirth S. Airway Disease. EMERGENCY RADIOLOGY OF THE CHEST AND CARDIOVASCULAR SYSTEM 2016. [PMCID: PMC7119984 DOI: 10.1007/174_2016_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Mariano Scaglione
- Dept of Radiology, Pineta Grande Medical Center, Castel Volturno, Caserta, Italy
| | | | | | - Ferco Berger
- VU University Medical Center, Amsterdam, The Netherlands
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Lynch DA, Austin JHM, Hogg JC, Grenier PA, Kauczor HU, Bankier AA, Barr RG, Colby TV, Galvin JR, Gevenois PA, Coxson HO, Hoffman EA, Newell JD, Pistolesi M, Silverman EK, Crapo JD. CT-Definable Subtypes of Chronic Obstructive Pulmonary Disease: A Statement of the Fleischner Society. Radiology 2015; 277:192-205. [PMID: 25961632 DOI: 10.1148/radiol.2015141579] [Citation(s) in RCA: 355] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this statement is to describe and define the phenotypic abnormalities that can be identified on visual and quantitative evaluation of computed tomographic (CT) images in subjects with chronic obstructive pulmonary disease (COPD), with the goal of contributing to a personalized approach to the treatment of patients with COPD. Quantitative CT is useful for identifying and sequentially evaluating the extent of emphysematous lung destruction, changes in airway walls, and expiratory air trapping. However, visual assessment of CT scans remains important to describe patterns of altered lung structure in COPD. The classification system proposed and illustrated in this article provides a structured approach to visual and quantitative assessment of COPD. Emphysema is classified as centrilobular (subclassified as trace, mild, moderate, confluent, and advanced destructive emphysema), panlobular, and paraseptal (subclassified as mild or substantial). Additional important visual features include airway wall thickening, inflammatory small airways disease, tracheal abnormalities, interstitial lung abnormalities, pulmonary arterial enlargement, and bronchiectasis.
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Affiliation(s)
- David A Lynch
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - John H M Austin
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - James C Hogg
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Philippe A Grenier
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Hans-Ulrich Kauczor
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Alexander A Bankier
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - R Graham Barr
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Thomas V Colby
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Jeffrey R Galvin
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Pierre Alain Gevenois
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Harvey O Coxson
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Eric A Hoffman
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - John D Newell
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Massimo Pistolesi
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - Edwin K Silverman
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
| | - James D Crapo
- From the Departments of Radiology (D.A.L.) and Medicine (J.D.C.), National Jewish Health, 1400 Jackson St, Denver, CO 80206; Department of Radiology, Columbia University, New York, NY (J.H.M.A.); Department of Pathology, University of British Columbia, Vancouver, BC, Canada (J.C.H.); Department of Radiology, Hôpital Pitié-Salpêtrière, Paris, France (P.A.G.); Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany (H.U.K.); Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Mass (A.A.B.); Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Department of Pathology, Mayo Clinic Scottsdale, Scottsdale, Ariz (T.V.C.); Department of Chest Imaging, American Institute for Radiologic Pathology, Silver Spring, Md (J.R.G.); Department of Radiology, Hôpital Erasme, Brussels, Belgium (P.A.G.); Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada (H.C.); Department of Radiology, Division of Physiological Imaging, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa (E.A.H., J.D.N.); Respiratory Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy (M.P.); and Channing Laboratory, Brigham and Women's Hospital, Boston, Mass (E.K.S.)
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Effect of low-dose, long-term roxithromycin on airway inflammation and remodeling of stable noncystic fibrosis bronchiectasis. Mediators Inflamm 2014; 2014:708608. [PMID: 25580060 PMCID: PMC4235134 DOI: 10.1155/2014/708608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 07/06/2014] [Accepted: 08/05/2014] [Indexed: 12/28/2022] Open
Abstract
Background. Noncystic fibrosis bronchiectasis (NCFB) is characterized by airway expansion and recurrent acute exacerbations. Macrolide has been shown to exhibit anti-inflammatory effects in some chronic airway diseases. Objective. To assess the efficacy of roxithromycin on airway inflammation and remodeling in patients with NCFB under steady state. Methods. The study involved an open-label design in 52 eligible Chinese patients with NCFB, who were assigned to control (receiving no treatment) and roxithromycin (receiving 150 mg/day for 6 months) groups. At baseline and 6 months, the inflammatory markers such as interleukin- (IL-)8, neutrophil elastase (NE), matrix metalloproteinase- (MMP)9, hyaluronidase (HA), and type IV collagen in sputum were measured, along with the detection of dilated bronchus by throat computed tomography scan, and assessed the exacerbation. Results. Forty-three patients completed the study. The neutrophil in the sputum was decreased in roxithromycin group compared with control (P < 0.05). IL-8, NE, MMP-9, HA, and type IV collagen in sputum were also decreased in roxithromycin group compared with the control group (all P < 0.01). Airway thickness of dilated bronchus and exacerbation were reduced in roxithromycin group compared with the control (all P < 0.05). Conclusions. Roxithromycin can reduce airway inflammation and airway thickness of dilated bronchus in patients with NCFB.
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Sabri YY, Hamdy Ibrahim IM, Radman AF. Bronchiolitis Obliterans (BO): HRCT findings in 20 patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2014. [DOI: 10.1016/j.ejrnm.2013.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hsieh MH, Fang YF, Chen GY, Chung FT, Liu YC, Wu CH, Chang YC, Lin HC. The role of the high-sensitivity C-reactive protein in patients with stable non-cystic fibrosis bronchiectasis. Pulm Med 2013; 2013:795140. [PMID: 24381758 PMCID: PMC3870862 DOI: 10.1155/2013/795140] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 09/26/2013] [Accepted: 10/18/2013] [Indexed: 11/23/2022] Open
Abstract
Study Objectives. The aim of this study is to investigate the correlation between serum high-sensitivity C-reactive protein (hs-CRP) and other clinical tools including high-resolution computed tomography (HRCT) in patients with stable non-CF bronchiectasis. Design. A within-subject correlational study of a group of patients with stable non-CF bronchiectasis, who were recruited from our outpatient clinic, was done over a two-year period. Measurements. Sixty-nine stable non-CF bronchiectasis patients were evaluated in terms of hs-CRP, 6-minute walk test, pulmonary function tests, and HRCT. Results. Circulating hs-CRP levels were significantly correlated with HRCT scores (n = 69, r = 0.473, P < 0.001) and resting oxygenation saturation (r = -0.269, P = 0.025). HRCT severity scores significantly increased in patients with hs-CRP level of 4.26 mg/L or higher (mean ± SD 28.1 ± 13.1) compared to those with hs-CRP level less than 4.26 mg/L (31.7 ± 9.8, P = 0.004). Oxygenation saturation at rest was lower in those with hs-CRP level of 4.26 mg/L or higher (93.5 ± 4.4%) compared to those with hs-CRP level less than 4.26 mg/L (96.4 ± 1.6%, P = 0.001). Conclusion. There was a good correlation between serum hs-CRP and HRCT scores in the patients with stable non-CF bronchiectasis.
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Affiliation(s)
- Meng-Heng Hsieh
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Yueh-Fu Fang
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Guan-Yuan Chen
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Fu-Tsai Chung
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Yuan-Chang Liu
- Department of Radiology, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Cheng-Hsien Wu
- Department of Radiology, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Yu-Chen Chang
- Department of Nuclear Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
| | - Horng-Chyuan Lin
- Department of Thoracic Medicine, Chang Gung Medical Foundation, Department of Chest Medicine, Chang Gung University, College of Medicine, Taoyuan 33342, Taiwan
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Habesoglu MA, Tercan F, Ozkan U, Fusun EO. Effect of radiological extent and severity of bronchiectasis on pulmonary function. Multidiscip Respir Med 2011; 6:284-90. [PMID: 22958727 PMCID: PMC3463082 DOI: 10.1186/2049-6958-6-5-284] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 02/10/2011] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to ascertain the effect of the extent and severity of bronchiectasis as determined with high-resolution computed tomography (HRCT) on lung function in patients with pure bronchiectasis, bronchiectasis and asthma, and bronchiectasis and chronic obstructive pulmonary disease (COPD). Methods One hundred nineteen patients (71 with pure bronchiectasis, 25 asthmatic patients with bronchiectasis, and 23 COPD patients with bronchiectasis) underwent HRCT and pulmonary function tests. Computed tomography features were scored by the consensus of 2 radiologists. Results There were no statistically significant differences among the 3 patient groups regarding the extent of bronchiectasis, bronchial dilatation degree, bronchial wall thickening, decreased attenuation in the lung parenchyma, or presence of mucus in the large and small airways. In the pure bronchiectasis group, a negative correlation was found between forced vital capacity (FVC) % of predicted, forced expiratory volume in 1 sec (FEV1) % of predicted, the FEV1/FVC ratio and the extent of bronchiectasis, bronchial wall thickening, bronchial wall dilatation, and decreased attenuation. At multivariate analysis the main morphologic changes associated with impairment of FVC and FEV1 were the extent of bronchiectasis and a decreased attenuation in the lung parenchyma. The decrease in the FEV1/FVC ratio was associated with bronchial wall dilatation. No correlation was found between morphologic changes and indices of pulmonary function in the asthma and COPD patients. Conclusions Morphologic changes associated with bronchiectasis do not influence lung function in patients with asthma and COPD directly, although they do play a role in impairing pulmonary function in patients with bronchiectasis alone.
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Affiliation(s)
- Mehmet A Habesoglu
- Department of Chest Disease, Baskent University Adana Teaching and Medical Research Center, Adana, Turkey.
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Abstract
Non-cystic fibrosis bronchiectasis is a heterogeneous condition and its pathogenesis is still not well defined. A combination of a defect in host defense and bacterial infection allows microbial colonization of the airways resulting in chronic inflammation and lung damage. An ongoing cycle of infection and inflammation may be established. Typically, the walls of the small airway are infiltrated by inflammatory cells causing obstruction whilst mediators, such as proteases released predominantly by neutrophils, damage the large airways resulting in bronchial dilatation. Adjacent parenchyma is also involved in the inflammation. Lung function testing generally demonstrates mild to moderate airflow obstruction that progresses over time. There are a large number of different aetiologic factors associated with bronchiectasis. A variety of different microbial pathogens is involved and they change as disease progresses.
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Affiliation(s)
- Paul King
- Department of Respiratory and Sleep Medicine and Monash University Department of Medicine, Monash Medical Centre, Melbourne, Australia.
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42
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Abstract
Current diagnostic labelling of childhood bronchiectasis by radiology has substantial limitations. These include the requirement for two high resolution computerised tomography [HRCT] scans (with associated adversity of radiation) if criteria is adhered to, adoption of radiological criteria for children from adult data, relatively high occurrence of false negative, and to a smaller extent false positive, in conventional HRCT scans when compared to multi-detector CT scans, determination of irreversible airway dilatation, and absence of normative data on broncho-arterial ratio in children. A paradigm presenting a spectrum related to airway bacteria, with associated degradation and inflammation products causing airway damage if untreated, entails protracted bacterial bronchitis (at the mild end) to irreversible airway dilatation with cystic formation as determined by HRCT (at the severe end of the spectrum). Increasing evidence suggests that progression of airway damage can be limited by intensive treatment, even in those predestined to have bronchiectasis (eg immune deficiency). Treatment is aimed at achieving a cure in those at the milder end of the spectrum to limiting further deterioration in those with severe 'irreversible' radiological bronchiectasis.
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Affiliation(s)
- A.B. Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT; Queensland Children's Respiratory Centre and Queensland Children's Medical Research Institute, Royal Children's Hospital, Brisbane, Australia
| | - C.A. Byrnes
- Paediatric Department, Faculty of Health & Medical Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - M.L. Everard
- Paediatric Respiratory Unit and Sheffield Children's Hospital, Western Bank, Sheffield, UK
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43
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Odry BL, Kiraly AP, Godoy MCB, Ko J, Naidich DP, Novak CL, Lerallut JF. Automated CT scoring of airway diseases: preliminary results. Acad Radiol 2010; 17:1136-45. [PMID: 20576450 DOI: 10.1016/j.acra.2010.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 04/27/2010] [Accepted: 04/28/2010] [Indexed: 11/18/2022]
Abstract
RATIONALE AND OBJECTIVES The aim of this study was to retrospectively evaluate an automated global scoring system for evaluating the extent and severity of disease in a known cohort of patients with documented bronchiectasis. On the basis of a combination of validated three-dimensional automated algorithms for bronchial tree extraction and quantitative airway measurements, global scoring combines the evaluation of bronchial lumen-to-artery ratios and bronchial wall-to-artery ratios, as well as the detection of mucoid-impacted airways. The result is an automatically generated global computed tomographic (CT) score designed to simplify and standardize the interpretation of scans in patients with chronic airway infections. MATERIALS AND METHODS Twenty high-resolution CT data sets were used to evaluate an automated CT scoring method that combines algorithms for airway quantitative analysis that have been individually tested and validated. Patients with clinically documented atypical mycobacterial infections with visually assessed CT evidence of bronchiectasis varying from mild to severe were retrospectively selected. These data sets were evaluated by two independent experienced radiologists and by computer scoring, with the results compared statistically, including Spearman's rank correlation. RESULTS Computer evaluation required 3 to 5 minutes per data set, compared to 12 to 15 minutes for manual scoring. Initial Spearman's rank tests showed positive correlations between automated and readers' global scores (r = 0.609, P = .01), extent of bronchiectasis (r = 0.69, P = .0004), and severity of bronchiectasis (r = 0.61, P = .01), while mucus plug detection showed a lesser extent of positive correlation between the scoring methods (r = 0.42, P = .07) and wall thickness a negative weak correlation (r = -0.10, P = .40). Further retrospective review of 24 lobes in which wall thickness scores showed the highest discrepancy between manual and automated methods was then performed, using electronic calipers and perpendicular cross-sections to reassess airway measurements. This resulted in an improved Spearman's rank correlation to r = 0.62 (P = .009), for a global score of r = 0.67 (P = .001). CONCLUSION Automated computerized scoring shows considerable promise for providing a standardized, quantitative method, demonstrating overall good correlation with the results of experienced readers' evaluation of the extent and severity of bronchiectasis. It is speculated that this technique may also be applicable to a wide range of other conditions associated with chronic bronchial inflammation, as well as of potential value for monitoring response to therapy in these same populations.
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Affiliation(s)
- Benjamin L Odry
- Imaging and Visualization Department, Siemens Corporate Research, Inc, Princeton, NJ 08540, USA.
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44
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Surgical treatment of bronchiectasis: a retrospective analysis of 790 patients. Ann Thorac Surg 2010; 90:246-50. [PMID: 20609785 DOI: 10.1016/j.athoracsur.2010.03.064] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2009] [Revised: 03/19/2010] [Accepted: 03/22/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND The global incidence of bronchiectasis is increasing, and this disease is prevalent in rural China. This study examined operative mortality, morbidity, and outcomes of surgery for bronchiectasis at a single institution in China. METHODS We retrospectively reviewed the medical records of 790 consecutive patients who underwent surgery for bronchiectasis in our department between January 1989 and December 2008. Localized bronchiectasis was diagnosed by high-resolution computed tomography. The persistence of symptoms after failure of nonsurgical treatment was an indication for surgery. Cystic fibrosis patients were excluded from this study. RESULTS The study sample included 790 patients (466 male, 324 female) who underwent 810 operations for bronchiectasis. Mean age at time of surgery was 41.6 years (range, 6 to 79 years). Several surgical procedures were used: lobectomy (497; 62.9%), segment resection (37; 4.7%), pneumonectomy (90; 11.3%), bilobectomy (56; 7.1%), and lobectomy and segmentectomy (110; 14.0%). There were no intraoperative deaths. Nine (1.1%) patients died in the postoperative period. Univariate analysis showed that advanced age (p = 0.04) and renal failure (p = 0.001) were associated with postoperative mortality, and multivariate analysis revealed that preoperative renal failure was associated with mortality (p = 0.025). The mean follow-up time was 4.2 years (range, 10 months to 10 years). After surgery, 478 (60.5%) patients were asymptomatic, 111 (14.1%) had improved, and 117 (14.8%) showed no improvement or worsened condition. CONCLUSIONS Localized bronchiectasis is usually the indication for surgical resection, which is a safe procedure with acceptable operative morbidity, mortality, and outcomes.
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Arakawa H, Fujimoto K, Fukushima Y, Kaji Y. Thin-section CT imaging that correlates with pulmonary function tests in obstructive airway disease. Eur J Radiol 2010; 80:e157-63. [PMID: 20619989 DOI: 10.1016/j.ejrad.2010.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Accepted: 06/08/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to identify independent CT findings that correlated with pulmonary function tests (PFTs) in patients with obstructive airway diseases. MATERIALS AND METHODS Sixty-eight patients with obstructive airway disease and 29 normal subjects (mean age, 52 years; 36 men and 61 women) underwent inspiratory and expiratory thin-section CT and PFTs. Patient with obvious emphysema was excluded. Two radiologists independently reviewed the images and semi-quantitatively evaluated lung attenuation (mosaic perfusion, air trapping) and airway abnormalities (extent and severity of bronchial wall thickening and bronchiectasis, bronchiolectasis or centrilobular nodules, mucous plugging). Univariate, multivariate and receiver operating characteristic (ROC) analyses were performed with CT findings and PFTs. RESULTS Forty-two patients showed obstructive PFTs, 26 symptomatic patients showed near-normal PFTs. On univariate analysis, air trapping and bronchial wall thickening showed highest correlation with obstructive PFTs such as FEV1.0/FVC, MMEF and FEF75 (r ranged from -0.712 to -0.782; p<0.001), while mosaic perfusion and mucous plugging showed moderate correlation, and bronchiectasis, bronchiolectasis and nodules showed the least, but significant, correlation. Multiple logistic analyses revealed air trapping and bronchial wall thickening as the only significant independent determinants of obstructive PFTs. ROC analysis revealed the cut-off value of air trapping for obstructive PFTs to be one-third of whole lung (area under curve, 0.847). CONCLUSIONS Our study confirmed air trapping and bronchial wall thickening are the most important observations when imaging obstructive PFTs. The cut-off value of air trapping for identifying obstructive PFTs was one-third of lung irrespective of inspiratory CT findings.
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Affiliation(s)
- Hiroaki Arakawa
- Department of Radiology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, Tochigi 321-0293, Japan.
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Entendendo a classificação, a fisiopatologia e o diagnóstico radiológico das bronquiectasias. REVISTA PORTUGUESA DE PNEUMOLOGIA 2010; 16:627-39. [DOI: 10.1016/s0873-2159(15)30057-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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47
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Yamashiro T, Matsuoka S, Estépar RSJ, Diaz A, Newell JD, Sandhaus RA, Mergo PJ, Brantly ML, Murayama S, Reilly JJ, Hatabu H, Silverman EK, Washko GR. Quantitative airway assessment on computed tomography in patients with alpha1-antitrypsin deficiency. COPD 2010; 6:468-77. [PMID: 19938971 DOI: 10.3109/15412550903341521] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The relationship between quantitative airway measurements on computed tomography (CT) and airflow limitation in individuals with severe alpha (1)-antitrypsin deficiency (AATD) is undefined. Thus, we planned to clarify the relationship between CT-based airway indices and airflow limitation in AATD. 52 patients with AATD underwent chest CT and pre-bronchodilator spirometry at three institutions. In the right upper (RUL) and lower (RLL) lobes, wall area percent (WA%) and luminal area (Ai) were measured in the third, fourth, and fifth generations of the bronchi. The severity of emphysema was also calculated in each lobe and expressed as low attenuation area percent (LAA%). Correlations between obtained measurements and FEV(1)% predicted (FEV(1)%P) were evaluated by the Spearman rank correlation test. In RUL, WA% of all generations was significantly correlated with FEV(1)%P (3rd, R = -0.33, p = 0.02; 4th, R = -0.39, p = 0.004; 5th, R = -0.57, p < 0.001; respectively). Ai also showed significant correlations (3rd, R = 0.32, p = 0.02; 4th, R = 0.34, p = 0.01; 5th, R = 0.56, p < 0.001; respectively). Measured correlation coefficients improved when the airway progressed distally from the third to fifth generations. LAA% also correlated with FEV(1)%P (R = -0.51, p < 0.001). In RLL, WA% showed weak correlations with FEV(1)%P in all generations (3rd, R = -0.34, p = 0.01; 4th, R = -0.30, p = 0.03; 5th, R = -0.31, p = 0.03; respectively). Only Ai from the fifth generation significantly correlated with FEV(1)%P in this lobe (R = 0.34, p = 0.01). LAA% strongly correlated with FEV(1)%P (R = -0.71, p < 0.001). We conclude therefore that quantitative airway measurements are significantly correlated with airflow limitation in AATD, particularly in the distal airways of RUL. Emphysema of the lower lung is the predominant component; however, airway disease also has a significant impact on airflow limitation in AATD.
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Affiliation(s)
- Tsuneo Yamashiro
- Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Boston, Massachusetts, USA.
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Kapur N, Masters IB, Chang AB. Longitudinal growth and lung function in pediatric non-cystic fibrosis bronchiectasis: what influences lung function stability? Chest 2010; 138:158-64. [PMID: 20173055 DOI: 10.1378/chest.09-2932] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Longitudinal FEV(1) data in children with non-cystic fibrosis (non-CF) bronchiectasis (BE) are contradictory, and there are no multifactor data on the evolution of lung function and growth in this group. We longitudinally reviewed lung function and growth in children with non-CF BE and explored biologically plausible factors associated with changes in these parameters over time. METHODS Fifty-two children with > or = 3 years of lung function data were retrospectively reviewed. Changes in annual anthropometry and spirometry at year 3 and year 5 from baseline were analyzed. The impact of sex, age, cause, baseline FEV(1), exacerbation frequency, radiologic extent, socioeconomic status, environmental tobacco smoke exposure, and period of diagnosis was evaluated. RESULTS Over 3 years, the group mean forced expiratory flow midexpiratory phase percent predicted and BMI z-score improved by 3.01 (P = .04; 95% CI, 0.14-5.86) and 0.089 (P = .01; 95% CI, 0.02-0.15) per annum, respectively. FEV(1)% predicted, FVC% predicted, and height z-score all showed nonsignificant improvement. Over 5 years, there was improvement in FVC% predicted (slope 1.74; P = .001) annually, but only minor improvement in other parameters. Children with immunodeficiency and those with low baseline FEV(1) had significantly lower BMI at diagnosis. Frequency of hospitalized exacerbation and low baseline FEV(1) were the only significant predictors of change in FEV(1) over 3 years. Decline in FEV(1)% predicted was large (but nonsignificant) for each additional year in age of diagnosis. CONCLUSIONS Spirometric and anthropometric parameters in children with non-CF BE remain stable over a 3- to 5-year follow-up period once appropriate therapy is instituted. Severe exacerbations result in accelerated lung function decline. Increased medical cognizance of children with chronic moist cough is needed for early diagnosis, better management, and improving overall outcome in BE.
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Affiliation(s)
- Nitin Kapur
- Queensland Children's Respiratory Centre and Queensland Children's Medical Research Institute, Department of Respiratory Medicine, Royal Children's Hospital, Herston, QLD 4029, Australia.
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Kwak HJ, Moon JY, Choi YW, Kim TH, Sohn JW, Yoon HJ, Shin DH, Park SS, Kim SH. High Prevalence of Bronchiectasis in Adults: Analysis of CT Findings in a Health Screening Program. TOHOKU J EXP MED 2010; 222:237-42. [DOI: 10.1620/tjem.222.237] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Hyun Jung Kwak
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Ji-Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Yo Won Choi
- Department of Radiology, Hanyang University College of Medicine
| | - Tae Hyung Kim
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Jang Won Sohn
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Dong Ho Shin
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Sung Soo Park
- Department of Internal Medicine, Hanyang University College of Medicine
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine
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50
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Abstract
Multidetector row computed tomography (MDCT) is the imaging modality of reference for the diagnosis of bronchiectasis. MDCT may also detect a focal stenosis, a tumor or multiple morphologic abnormalities of the bronchial tree. It may orient the endoscopist towards the abnormal bronchi, and in all cases assess the extent of the bronchial lesions. The CT findings of bronchial abnormalities include anomalies of bronchial division and origin, bronchial stenosis, bronchial wall thickening, lumen dilatation, and mucoid impaction. The main CT features of bronchiectasis are increased bronchoarterial ratio, lack of bronchial tapering, and visibility of peripheral airways. Other bronchial abnormalities include excessive bronchial collapse at expiration, outpouchings and diverticula, dehiscence, fistulas, and calcifications.
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