Improved plain film criteria for the diagnosis of bronchiectasis
Woodring, J.H.
Journal of the Kentucky Medical Association 92(1): 8-13
1994
ISSN/ISBN: 0023-0294 PMID: 8120445 Document Number: 424894
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.