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Bronchiectasis
1.
Bronchiectasis Dr / Hytham
Nafady
2.
Definition • Irreversible dilatation
of the cartilage containing airways.
3.
4.
Bronchial tree
5.
6.
Types of bronchiectasis
7.
Cylindrical bronchiectasis Varicose bronchiectasis Cystic bronchiectasis Mild Moderate Sever Tram
track appearance String of beads Cluster of grapes
8.
Cylindrical bronchiectasis
9.
Varicose bronchiectasis
10.
Cystic bronchiectasis
11.
Plain radiographic signs
of bronchiectasis
12.
13.
14.
Mucoid impaction
15.
Fluid filled bronchi
16.
CTsigns of bronchiectasis
17.
•Signet ring sign
(broncho-arterial ratio > 1). •Lack of bronchial tapering. •Abnormal bronchial contour. •Visibility of peripheral air ways.
18.
Signet ring sign broncho-arterial
ratio > 1
19.
Normal bronchus Lack
of bronchial tapering
20.
Abnormal bronchial contour
21.
Visibility of peripheral
air ways within 1cm from the costal pleura
22.
• Peribronchial cuffing
(thickened hazy bronchial wall). • Finger in glove opacities (mucus filled bronchi). • Multiple air fluid levels (fluid filled bronchi).
23.
Bronchial wall thickening
24.
Mucoid impaction
25.
Multiple air fluid
levels
26.
• Mosaic perfusion. •
Air trapping. • Tree in bud opacities.
27.
Mosaic perfusion
28.
Air trapping
29.
Tree in budd
opacities
30.
Pseudo-bronchiectasis • Pitfalls in
diagnosis of bronchiectasis. • Motion artifact (respiratory or cardiac motion artifact).
31.
32.
33.
Endobronchial tumor (carcinoid)
34.
Broncholithiasis
35.
Bronchial atresia
36.
Bronchial stenosis
37.
Post-irradiation fibrosis (traction bronchiectasis)
38.
39.
Diffuse bronchiectasis with central
predominance • ABPA. • Mounier Kuhn syndrome. • William Campbell syndrome.
40.
ABPA
41.
Mounier Kuhn syndrome tracheobronchomegaly
42.
William Campbell syndrome Congenital
cystic bronchiectasis that results from a deficiency of cartilage in the 4th to 6th order bronchi
43.
Diffuse bronchiectasis with upper
lobe predominance • Cystic fibrosis. • Sarcoidosis.
44.
Cystic fibrosis
45.
Sarcoidosis
46.
Diffuse bronchiectasis with middle
lobe & lingula predominance • Non tuberculous mycobacterial infection. • Immobile cilia syndrome.
47.
Mycobacterium avium intercellulare infection
48.
Immotile cilia syndrome
49.
Bronchiectasis with lower lobe
predominance 1. Idiopathic (40% of cases). 2. Recurrent childhood infection. 3. Repeated aspiration. 4. Interstitial lung disease.
50.
Interstitial lung disease
51.
Case • 65-year-old man
with a chronic productive cough and progressive dyspnea on exertion.
52.
53.
54.
Atlas of bronchiectasis
55.
56.
Bronchietasis Lack of bronchial tapering + Tree
in bud opacities
57.
58.
LUL bronchiectasis
59.
60.
RML bronchiectasis