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High-Resolution CT Quantification of Bronchiectasis: Clinical and Functional Correlation¹

¹ From the Departments of Diagnostic Radiology (G.C.O., P.L.K.) and Medicine (M.C.Y., J.C.M.H., W.K.L., K.W.T.T.), University of Hong Kong, Queen Mary Hospital, 806, Administration Block, Hong Kong SAR, China; and Faculty of Medicine, University of Hong Kong (P.K.S.C., J.C.K.L.). Received September 24, 2001; revision requested November 26; final revision received March 27, 2002; accepted April 29. Supported by a Committee for Research and Conference grant from the University of Hong Kong. Address correspondence to K.W.T.T. (e-mail: kwttsang@hku.hk).

PURPOSE: To evaluate clinical relevance of high-resolution computed tomographic (CT) findings in patients with bronchiectasis by using a quantitative high-resolution CT protocol to assess extent of bronchiectasis, severity of bronchial wall thickening, and presence of small-airway abnormalities and mosaic pattern.

MATERIALS AND METHODS: Sixty Chinese patients with steady-state bronchiectasis underwent thoracic high-resolution CT and lung function tests. Exacerbation frequency per year and 24-hour sputum volume were determined. Extent of bronchiectasis, severity of bronchial wall thickening, and presence of small-airway abnormalities and mosaic attenuation were evaluated in each lobe, including the lingula. Differences between sex and smoking status with respect to high-resolution CT, lung function, and clinical parameters were tested with either the independent sample t test or the Mann-Whitney test. Spearman rank correlation was used to evaluate associations between clinical, lung function, and high-resolution CT scores. Multiple regression analyses were performed to determine which high-resolution CT parameters would best predict lung function and clinical parameters, adjusted for smoking.

RESULTS: Exacerbation frequency was associated with bronchial wall thickening (r = 0.32, P = .03); 24-hour sputum volume with bronchial wall thickening and small-airway abnormalities (r = 0.30 and 0.39, respectively; P < .05); and forced expiratory volume in 1 second (FEV₁), ratio of FEV₁ to forced vital capacity (FVC), and midexpiratory phase of forced expiratory flow (FEF_25%-75%) (r = -0.33, -0.29, and -0.32, respectively; P < .05). Extent of bronchiectasis, bronchial wall thickening, and mosaic attenuation, respectively, were related to FEV₁ (r = -0.43 to -0.60, P < .001), FEF_25%-75% (r = -0.38 to -0.57, P < .001), FVC (r = -0.36 to -0.46, P < .01), and FEV₁/FVC ratio (r = -0.31 to -0.49, P < .01). After multiple regression analysis, bronchial wall thickening remained a significant determinant of airflow obstruction, whereas small-airway abnormalities remained associated with 24-hour sputum volume. Women had milder disease than men but showed more high-resolution CT functional correlations.

CONCLUSION: Findings of this study establish a link between morphologic high-resolution CT parameters and clinical activity and emphasize the role of bronchial wall thickening in patients with bronchiectasis.

© RSNA, 2002

Index terms: Bronchiectasis, 60.26 • Lung, CT, 60.12118

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