Bronchiectasis

Pathway

Images

Image Gallery Note: These images open in a new page
1a		Cystic Bronchiectasis Image 1 (Plain Radiograph): Severe cystically dilated bronchi most marked in the upper lung zones bilaterally due to cystic fibrosis.
2		Cystic Bronchiectasis Image 2 (Computed Tomography): Multicystic space within the base of the left lower lobe which is continuous with the small airways and is representative of cystic bronchiectasis.
3a		Cystic Bronchiectasis Image 3a: Pneumonectomy showing grossly dilated bronchi with mucous plugging (blue arrows) and distal consolidation.
3b		Image 3b (H&E, x2.5): Section of a dilated bronchi with florid acute on chronic inflammation of the bronchial wall and surrounding interstitial fibrosis.

Teaching Points

Teaching Points

• Bronchiectasis is a clinical syndrome involving irreversible damage and dilatation of the bronchi
  • The diagnosis of bronchiectasis requires the presence of clinical symptoms as well as characteristic radiographic features on chest CT
• A chest radiograph is useful to exclude other causes of the patient’s symptoms. In severe disease, it can demonstrate changes of bronchiectasis
• Chest CT is the investigation of choice to define the type and extent of bronchiectasis

References

References

Date of literature search: April 2018

References are graded from Level I to V according to the Oxford Centre for Evidence-Based Medicine, Levels of Evidence. Download the document

1. Thoracic Society of Australia and New Zealand. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand. Clinical practice guideline. 2014. (Guideline). View the reference
2. Altenburg J, Wortel K, van der Werf TS, Boersma WG. Non-cystic fibrosis bronchiectasis: clinical presentation, diagnosis and treatment, illustrated by data from a Dutch Teaching Hospital. Neth J Med. 2015;73(4):147-54. (Review article). View the reference
3. Milliron B, Henry TS, Veeraraghavan S, Little BP. Bronchiectasis: Mechanisms and imaging clues of associated common and uncommon diseases. Radiographics. 2015;35(4):1011-30. (Review article). View the reference
4. Maselli DJ, Amalakuhan B, Keyt H, Diaz AA. Suspecting non‐cystic fibrosis bronchiectasis: What the busy primary care clinician needs to know. Int J Clin Pract. 2017;71(2):e12924. (Review article). View the reference
5. Martinez-Garcia MA, Soler-Cataluna JJ, Donat Sanz Y, Catalan Serra P, Agramunt Lerma M, Ballestin Vicente J, et al. Factors associated with bronchiectasis in patients with COPD. Chest. 2011;140(5):1130-7. (Level III evidence). View the reference
6. Tasker AD, Flower CD. Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease. Clin Chest Med. 1999;20(4):761-73, viii. (Review article). View the reference
7. Kumar NA, Nguyen B, Maki D. Bronchiectasis: current clinical and imaging concepts. Semin Roentgenol. 2001;36(1):41-50. (Review article). View the reference
8. Munro NC, Han LY, Currie DC, Strickland B, Cole PJ. Radiological evidence of progression of bronchiectasis. Respir Med. 1992;86(5):397-401. (Level III evidence). View the reference
9. van der Bruggen-Bogaarts BA, van der Bruggen HM, van Waes PF, Lammers JW. Screening for bronchiectasis. A comparative study between chest radiography and high-resolution CT. Chest. 1996;109(3):608-11. (Level II-III evidence). View the reference
10. Pasteur MC, Bilton D, Hill AT. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010;65 Suppl 1:i1-58. (Guideline). View the reference
11. Ellis S, Aziz Z. Radiology as an aid to diagnosis in lung disease. Postgrad Med J. 2016;92(1092):620-3. (Review article). View the reference
12. Little BP, Duong PT. Imaging of diseases of the large airways. Radiol Clin North Am. 2016;54(6):1183-203. (Review article). View the reference
13. Cantin L, Bankier AA, Eisenberg RL. Bronchiectasis. Am J Roentgenol. 2009;193(3):W158-W71. (Review article). View the reference
14. Greene KE, Takasugi JE, Godwin JD, Richardson ML, Burke W, Aitken ML. Radiographic changes in acute exacerbations of cystic fibrosis in adults: a pilot study. AJR Am J Roentgenol. 1994;163(3):557-62. (Level III evidence). View the reference
15. Kang EY, Miller RR, Muller NL. Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens. Radiology. 1995;195(3):649-54. (Level IV evidence). View the reference
16. Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R. Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology. 1993;188(3):829-33. (Level III evidence). View the reference
17. Bonavita J, Naidich DP. Imaging of bronchiectasis. Clin Chest Med. 2012;33(2):233-48. (Review article). View the reference
18. Dodd JD, Lavelle LP, Fabre A, Brady D. Imaging in cystic fibrosis and non-cystic fibrosis bronchiectasis. Semin Respir Crit Care Med. 2015;36(2):194-206. (Review article). View the reference
19. Barker AF. Bronchiectasis. N Engl J Med. 2002;346(18):1383-93. (Review article). View the reference
20. Cartier Y, Kavanagh PV, Johkoh T, Mason AC, Muller NL. Bronchiectasis: accuracy of high-resolution CT in the differentiation of specific diseases. AJR Am J Roentgenol. 1999;173(1):47-52. (Level II-III evidence). View the reference
21. Reiff DB, Wells AU, Carr DH, Cole PJ, Hansell DM. CT findings in bronchiectasis: limited value in distinguishing between idiopathic and specific types. AJR Am J Roentgenol. 1995;165(2):261-7. (Level II-III evidence). View the reference
22. Dodd JD, Souza CA, Muller NL. Conventional high-resolution CT versus helical high-resolution MDCT in the detection of bronchiectasis. AJR Am J Roentgenol. 2006;187(2):414-20. (Level II evidence). View the reference
23. Hill LE, Ritchie G, Wightman AJ, Hill AT, Murchison JT. Comparison between conventional interrupted high-resolution CT and volume multidetector CT acquisition in the assessment of bronchiectasis. The British Journal of Radiology. 2010;83(985):67-70. (Level II evidence). View the reference

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