title: Improved plain film criteria for the diagnosis of bronchiectasis.
abstract: This manuscript establishes criteria that allow more accurate detection of bronchiectasis from plain films. Chest radiographs of 38 patients with proven bronchiectasis were evaluated for seven radiologic signs: bronchial dilatation, identified by visually comparing bronchial diameters in affected areas to bronchial diameters in normal areas an equal distance from the hilum; signet ring sign, with dilated, thick-walled bronchus adjacent to a smaller companion artery; bronchial wall thickening; volume loss; compensatory hyperinflation of surrounding segments or lobes; mucoid impaction of bronchi; and obvious cyst formation. The chest radiograph was abnormal in all 38 cases. Bronchial dilatation was present in 100%, signet ring sign in 79%, bronchial wall thickening in 92%, volume loss in 97%, compensatory hyperinflation in 58%, mucoid impaction in 45%, and cyst formation in 42%. By combining these signs, a very certain diagnosis of bronchiectasis was possible. Measurements of the pulmonary artery-bronchus ratio (ABR) in cases demonstrating the signet ring sign were useful in validating the signet ring sign as a good sign of bronchiectasis on plain films. Overall, the chest radiograph showed 235 (92%) of the 255 bronchiectatic lung segments identified by bronchography or high-resolution computed tomography.
authors.affiliation: Department of Diagnostic Radiology, University of Kentucky Medical Center, Lexington 40536-0084.
authors.forename: J H
authors.initials: JH
authors.lastname: Woodring
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001987:Bronchiectasis / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods