title: Traction bronchiectasis in cryptogenic fibrosing alveolitis: associated computed tomographic features and physiological significance.
abstract: Our objective was to evaluate the associated CT features and physiological consequences of traction bronchiectasis in patients with cryptogenic fibrosing alveolitis (CFA). The CT scans of 212 patients with CFA (158 men, 54 women; mean age 62.2+/-10.6 years) were evaluated independently by two observers. The extent of fibrosis, the proportions of a reticular pattern and ground-glass opacification and the extent of emphysema were scored at five levels. The predominant CT pattern, coarseness of a reticular pattern and severity of traction bronchiectasis were graded semiquantitatively. Physiological indices were correlated with CT features. There was traction bronchiectasis on CT in 202 of 212 (95%) patients. Increasingly severe traction bronchiectasis was independently associated with increasingly extensive CFA ( p<0.0005), a coarser reticular pattern ( p<0.001), a lower proportion of ground-glass opacification ( p<0.005) and less extensive emphysema ( p<0.0005). Increasingly severe traction bronchiectasis was independently related to depression of DL(CO) ( p<0.005), FVC ( p=0.02) and pO(2) ( p<0.0005), but not indices of air-flow obstruction. In CFA, traction bronchiectasis increases with more extensive disease, a lower proportion of ground-glass opacification and a coarser reticular pattern, but it decreases with concurrent emphysema. Increasingly severe traction bronchiectasis is associated with additional physiological impairment for a given extent of pulmonary fibrosis and emphysema.
authors.affiliation: Department of Radiology, King's College Hospital, Denmark Hill, SE5 9RS London, UK. sujal.desai@kingsch.nhs.uk
authors.forename: Sujal R
authors.initials: SR
authors.lastname: Desai
authors.forename: Athol U
authors.initials: AU
authors.lastname: Wells
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rubens
authors.forename: Roland M
authors.initials: RM
authors.lastname: du Bois
authors.forename: David M
authors.initials: DM
authors.lastname: Hansell
mesh_terms: D001987:Bronchiectasis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed