Dodd Jonathan D, Lavelle Lisa P, Fabre Aurelie, Brady Darragh
Department of Radiology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland.
Department of Pathology, St. Vincent's University Hospital, Elm Park, Dublin, Ireland.
Semin Respir Crit Care Med. 2015 Apr;36(2):194-206. doi: 10.1055/s-0035-1546749. Epub 2015 Mar 31.
Bronchiectasis is defined as a permanent and progressive dilation of the airways, typically as a result of inflammation, infection, and subsequent repair. It typically presents with chronic cough, suppurative sputum production, and airway dilation. High-resolution computed tomography (HRCT) is now well established as the primary imaging tool for its investigation. Cystic fibrosis (CF) remains the most common autosomal recessive inherited disorder worldwide and its pulmonary hallmark is bronchiectasis. Although CF and non-CF bronchiectasis are different clinical entities, they are typically imaged using HRCT and share many imaging aspects, and also some differences. Several important recent CT technology developments have improved the detection and characterization of bronchiectasis and its complications. Many CT aspects of radiation exposure have also undergone important enhancements in recent years resulting in significant dose reductions. This is particularly relevant in a pulmonary disease such as bronchiectasis, which often undergoes serial HRCT surveillance in contemporary practice. Several new CT clinical applications in bronchiectasis have been recently advanced, and CT is now being increasingly incorporated into investigative algorithms to assess bronchiectasis treatment effects. In this review, we assess the latest imaging features of CF and non-CF bronchiectasis, discuss radiation dose reducing methods and technology of the latest scanners, describe recent CT clinical applications, and explore the use of CT as a treatment surrogate in CF and non-CF bronchiectasis.
支气管扩张症的定义为气道的永久性和进行性扩张，通常是炎症、感染及后续修复的结果。其典型表现为慢性咳嗽、脓性痰液生成和气道扩张。高分辨率计算机断层扫描（HRCT）现已成为其主要的影像学检查工具。囊性纤维化（CF）仍是全球最常见的常染色体隐性遗传性疾病，其肺部特征为支气管扩张症。尽管CF相关性支气管扩张症和非CF相关性支气管扩张症是不同的临床实体，但它们通常都采用HRCT进行成像，有许多共同的影像学特征，也存在一些差异。近年来，CT技术的几项重要进展改善了支气管扩张症及其并发症的检测和特征描述。近年来，CT在辐射剂量方面的许多方面也有了重要改进，使辐射剂量大幅降低。这在支气管扩张症这类肺部疾病中尤为重要，因为在现代临床实践中，支气管扩张症患者常常需要接受HRCT的系列监测。最近，支气管扩张症的几项新的CT临床应用取得了进展，CT现在越来越多地被纳入评估支气管扩张症治疗效果的检查方案中。在这篇综述中，我们评估了CF相关性支气管扩张症和非CF相关性支气管扩张症的最新影像学特征，讨论了辐射剂量降低方法和最新扫描仪技术，描述了近期CT的临床应用，并探讨了CT在CF相关性支气管扩张症和非CF相关性支气管扩张症中作为治疗替代指标的应用。
