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Updated: Feb 28, 2026

Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
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Radiological Phenotypes of Bronchiectasis Based on Airway Generation.

Xueqing Yang1, Jianping Song1, Hongqing Zhang1

  • 1Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Biomedicines
|February 27, 2026
PubMed
Summary
This summary is machine-generated.

Bronchiectasis has distinct radiological phenotypes linked to airway generation. These differences impact clinical severity, inflammation, and microbiome, guiding personalized treatment for better patient outcomes.

Keywords:
airway generationbronchiectasisradiological phenotype

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Area of Science:

  • Pulmonology
  • Radiology
  • Microbiology
  • Metabolomics

Background:

  • High-resolution computed tomography (HRCT) shows significant radiological heterogeneity in bronchiectasis.
  • Clinical characteristics associated with these radiological patterns remain unclear.
  • Understanding these differences is crucial for effective bronchiectasis management.

Purpose of the Study:

  • To investigate the clinical, inflammatory, microbial, and metabolic features of distinct bronchiectasis radiological phenotypes.
  • To classify patients into distal airway (DA) and proximal-intermediate airway (PIA) phenotypes based on HRCT findings.
  • To compare disease severity and exacerbation rates between these phenotypes.

Main Methods:

  • Prospective observational cohort study of 334 bronchiectasis patients.
  • Classification into DA and PIA phenotypes based on radiological assessment.
  • Regular follow-up to record exacerbations, alongside comprehensive clinical, inflammatory, microbial, and metabolomic profiling.

Main Results:

  • The DA phenotype was associated with lower FEV1%pred, higher Bhalla and FACED scores, and more frequent exacerbations.
  • DA phenotype showed increased Pseudomonas aeruginosa colonization and more extensive lung damage.
  • PIA phenotype had a higher prevalence of allergic bronchopulmonary aspergillosis and distinct inflammatory profiles (eosinophilic).
  • Microbiome analysis revealed unique ecological structures for each phenotype.
  • Elevated 4-hydroxynonenal levels were observed in the DA group, correlating with higher exacerbation rates.

Conclusions:

  • Distinct radiological phenotypes in bronchiectasis, defined by airway generation, correlate with significant differences in clinical presentation and disease severity.
  • These phenotypes exhibit unique inflammatory responses, microbial compositions, and metabolic profiles.
  • Identifying these radiological phenotypes can facilitate personalized management strategies for bronchiectasis patients.