Chassagnon G, Brun A-L, Bennani S, Chergui N, Freche G, Revel M-P
Unité d'imagerie thoracique, groupe hospitalier Cochin-Broca-Hôtel-Dieu, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Unité d'imagerie thoracique, groupe hospitalier Cochin-Broca-Hôtel-Dieu, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Rev Pneumol Clin. 2018 Oct;74(5):299-314. doi: 10.1016/j.pneumo.2018.09.009. Epub 2018 Oct 19.
Bronchiectasis are defined as an irreversible focal or diffuse dilatation of the bronchi and can be associated with significant morbidity. The prevalence is currently increasing, probably due to an increased use of thoracic computed tomography (CT). Indeed, the diagnosis relies on imaging and chest CT is the gold standard technique. The main diagnosis criterion is an increased bronchial diameter as compared to that of the companion artery. However, false positives are possible when the artery diameter is decreased, which is called pseudo-bronchiectasis. Other features such as the lack of bronchial tapering, and visibility of bronchi within 1cm of the pleural surface are also diagnostic criteria, and other CT features of bronchial disease are commonly seen. Thoracic imaging also allows severity assessment and long-term monitoring of structural abnormalities. The distribution pattern and the presence of associated findings on chest CT help identifying specific causes of bronchiectasis. Lung MRI and ultra-low dose CT and are promising imaging modalities that may play a role in the future. The objectives of this review are to describe imaging features for the diagnosis and severity assessment of bronchiectasis, to review findings suggesting the cause of bronchiectasis, and to present the new developments in bronchiectasis imaging.
支气管扩张症被定义为支气管不可逆的局灶性或弥漫性扩张,可伴有严重的发病率。目前其患病率正在上升,这可能归因于胸部计算机断层扫描(CT)使用的增加。事实上,诊断依赖于影像学检查,胸部CT是金标准技术。主要诊断标准是与伴行动脉相比支气管直径增大。然而,当动脉直径减小时可能会出现假阳性,这被称为假性支气管扩张。其他特征,如支气管缺乏逐渐变细以及在胸膜表面1厘米内可见支气管,也是诊断标准,并且支气管疾病的其他CT特征也很常见。胸部影像学检查还可用于评估严重程度以及对结构异常进行长期监测。胸部CT上的分布模式和相关表现有助于确定支气管扩张症的具体病因。肺部磁共振成像(MRI)和超低剂量CT是有前景的成像方式,可能在未来发挥作用。本综述的目的是描述支气管扩张症诊断和严重程度评估的影像学特征,回顾提示支气管扩张症病因的发现,并介绍支气管扩张症影像学的新进展。