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Allergic Bronchopulmonary Aspergillosis (ABPA)-The High Resolution Computed Tomography (HRCT) Chest Imaging Scenario
Manjot Kaur1, Dharampal Singh Sudan2
1Professor, Department of Radiodiagnosis, Adesh Institute of Medical Sciences and Research , Bathinda, India .
Introduction:
Allergic bronchopulmonary aspergillosis (ABPA) is a progressive disease which can lead to recurrent exacerbations, bronchiectatic changes and end-stage fibrosis. Early diagnosis and treatment prevents its progression and alleviate its clinical manifestations. High resolution CT of the chest has emerged as a promising investigation for its diagnosis.
Aims And Objectives:
To review the high resolution computed tomography (HRCT) chest manifestations in ABPA patients.
Materials And Methods:
This study included 110 patients with ABPA who had undergone HRCT of the chest in the routine diagnostic workup for ABPA. The scans were assessed for changes in bronchi, parenchyma and pleura and findings consistent with ABPA were evaluated.
Results:
HRCT chest was normal in 24 patients. 86 patients demonstrated central bronchiectasis with predilection for upper and middle lobes. Centrilobular nodules with or without linear opacities (tree in bud pattern), mucoceles and high-attenuation mucus were seen in 86%, 59% and 36% patients respectively.
Conclusion:
Central bonchiectasis combined with centrilobular nodules and mucus impaction (especially high attenuation mucus) strongly favour the diagnosis of ABPA.
Insights
High-resolution CT (HRCT) of the chest is crucial for diagnosing allergic bronchopulmonary aspergillosis (ABPA). Key HRCT findings include central bronchiectasis, nodules, and mucus impaction, aiding early detection and treatment.
Area of Science:
- Pulmonology
- Radiology
- Medical Imaging
Background:
- Allergic bronchopulmonary aspergillosis (ABPA) is a progressive lung disease.
- ABPA can lead to bronchiectasis, fibrosis, and recurrent exacerbations.
- Early diagnosis and treatment are vital to prevent disease progression.
Purpose of the Study:
- To review the high-resolution computed tomography (HRCT) chest manifestations in patients with ABPA.
- To identify characteristic HRCT findings indicative of ABPA.
Main Methods:
- A study involving 110 patients diagnosed with ABPA.
- All patients underwent HRCT of the chest as part of their diagnostic workup.
- HRCT scans were analyzed for bronchial, parenchymal, and pleural changes.
Main Results:
- HRCT scans were normal in 24 patients.
- 86 patients showed central bronchiectasis, predominantly in the upper and middle lobes.
- Common findings included centrilobular nodules (86%), mucoceles (59%), and high-attenuation mucus (36%).
Conclusions:
- Central bronchiectasis is a significant HRCT finding in ABPA.
- The presence of centrilobular nodules and mucus impaction, particularly high-attenuation mucus, strongly suggests ABPA.
- HRCT is a valuable tool for diagnosing ABPA.
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