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BACKGROUND Bronchiectasis and cavitation are key features of acute and chronic pulmonary infections. Cavitary lesions may carry unfavourable prognosis with regard to complete restoration of pulmonary function in few patients. OBJECTIVES To evaluate type and site of bronchiectasis, its relation with cavity formation on computed tomography and providing an insight to sorting out subjects suited for physiotherapy. A radiological sign-“Feeding bronchus sign” has been discussed with reference to bronchiectasis, its origin, natural course and a suggestion of guarded future management and rehabilitation. METHODS Total 150 chest CT scans with presence of cavity and bronchiectasis were retrospectively reviewed and followed up for type, site of bronchiectasis, signs of active infection, site of cavity and presence of “feeding bronchus sign”. Final diagnosis was confirmed by sputum sample, acid-fast bacillus test or culture or polymerase chain reaction. RESULTS Out of 150 cases, 70 (46%) had chronic and 80 (53%) had active infection. 33 (22%) had solitary and 117 (78%) had multiple cavities. 37 (34.6 %) patients had cylindrical, 11 (7.3 %) had varicose, 27 (18%) had cystic bronchiectasis, 23 (15.3%) had cylindrical and varicose, 19 (12.6%) had cylindrical and cystic and 33 (22%) had all three types. “Feeding bronchus sign” was observed in 102 (68%) patients. Radiological evidence of disease progression was seen in 21 patients, improvement in 19 and no change in 17 on follow-up CT. CONCLUSION Patients with positive “Feeding bronchus sign” are at risk for increased disease transmission and secondary opportunistic infections. Improvement and maintenance of quality of life is ultimate goal of management. Apart from antibiotics, pulmonary rehabilitation also plays an important role in cavitary lung disease
ABSTRACT
Objective To study on the directing role of multi-slice spiral CT and multiplanar reformation(MPR)in bronchoscopy and enhance the yield of peripheral pulmonary carcinoma(PPC).Methods This study was carried in 60 PPC patients from Respiratory Department in the First Hospital Affilliated to Suzhou University during 2002—2005.They underwent MSCT.Images were reconstructed with MPR(CPR)to evaluate the relationship between PPC and bronchi and the type of BS was identified.Compare the diagnosed yields of bronchoscopic multiple diagnostic procedure(BMDPs)with types of BS.Results (1)In all patients the third to the seventh level branches of the bronchi were clearly shown.The tumor-bronchus relationship was identified as four types on MSCT.(2)MSCT demonstrated the BS in 22 of 25 adenocarcinomas and 13 of 17 squamous-cell carcinomas and 4 of 6 small cell lung carcinomas and 4 of 8 bronchiolo-alveolar carcinomas.(3)BS typeⅠwas shown in 15of 48(31.3%).Type Ⅱ was seen in 7 of 48(14.6%).Type Ⅲ was shown in 12 of 48(25%)squamous tumors.Type Ⅳ was seen in 14 of 48(29.2%).(4)Total positive rate of bronchoscopy was 58.3%,73.3% with BS and 13.3% without BS.Type of BS was closely associated with positive rate of BMDPs.Conclusion Axial CT and MPR can show the relationship between PPC and bronchi better.BS can direct fiberoptic bronchoscopy(FOB)diagnosis procedure and enhance the yield of PPC.