Role of computed tomography in the recognition of bronchiectasis

To assess the accuracy of computed tomography (CT) in the recognition of bronchiectasis, CT was performed in 11 patients with clinical findings strongly suggestive of this diagnosis. In two patients, CT showed extensive bilateral cystic and varicose bronchiectasis, and bronchography was considered unwarranted. In four patients, bilateral, and in five, unilateral bronchograms were obtained. Correlation was made between the CT and bronchographic findings in these 13 lungs. In only six bronchograms did CT give an accurate assessment of the presence and extent of disease. In five, the diagnosis of cylindrical and varicose bronchiectasis was missed on CT. In two, CT suggested the diagnosis of cylindrical bronchiectasis but the bronchogram was normal. It was concluded that CT may be useful in the diagnosis of cystic bronchiectasis, but is unreliable in detecting cylindrical and varicose changes. Bronchography, therefore, remains the definitive method for establishing the diagnosis, extent, and severity of bronchiectasis.