High-resolution CT quantification of bronchiectasis: clinical and functional correlation

Abstract

Introduction:With the widespread availability of HRCT it has been realized that bronchiectasis remains a common and important cause of respiratory disease. To evaluate the relationships between the extent and severity of bronchiectasis on CT and clinical symptoms, spirometric abnormality, and sputum characteristics. Materials and methods:We prospectively evaluated 40 patients with non-CF bronchiectasis confirmed by chest HRCT. Etiology, radiological modified Reiff score, microbiological profile and lung function tests were analised. Discussion results: Among the 40 enrolled patients (mean age was 56,32±14,7 %, men-48%) with bronchiectasis, the etiology was established in 70%. The most common underlying causes were past tuberculosis (32%) and COPD related (13%). In a smaller number of cases bronchiectasis were related rare causes (5%). Obstructive pattern was observed in 90 % (with a mean FEV1% 46±23,9%). Patients with cystic bronchiectasis (77%) were significantly more likely to grow Pseudomonas (23%) from their sputa and to have purulent sputa than were patients with cylindric or varicose bronchiectasis. Patients with cystic bronchiectasis had significantly lower FEV1 (44±23,8%) and FVC (57±21,2%) values than did patients with cylindric bronchiectasis FEV1 (65±21%) and FVC (72±13%). Reiff score correlated with FEV1 ( r = -0.662, p < 0.05 ) and with FVC (r = -0.656, p < 0.05 ) Conclusion: In this patient population, we found weak but significant correlations between the degree of morphologic abnormality on CT and the extent of physiologic impairment. Cystic bronchiectasis was Associated with sputum purulence and with the growth of Pseudomonas. CT classification of the type of bronchiectasis may be useful as an index of severity of the disease.