Sutton 3 bronchiectasis

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Sutton 3 bronchiectasis

  1. 1. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 1Free Powerpoint Templates Presentant : Reni Indrastuti Konsultant : dr. H. Edy Moeljono, Sp.Rad (K), RA Text Book Reading David Sutton Radiology and Imaging 7thth ed vol.1 Section 1, page 163-165 “Disease of The Airway” BronchiectasisBronchiectasis
  2. 2. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 2 Introduction Definition • Most common in children, • Increasing breathlessness •Chronic cough with excess sputum • Hemoptysis • Recurent infection with exacerbasi akut is the irreversible dilatation of one or more bronchi, and is usually the result of severe, recurrent or chronic infection A–Z of Chest Radiology David Sutton Bronchiectasis usually involves the peripheral bronchi more severely than the central bronchi Clinical presentation
  3. 3. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 3 Anatomy of the bronchi • The trachea bifurcates, giving rise to the left and right main stem bronchi. • the right main stem bronchus is more vertical, wider by about 2 mm, and approximately half the length of the left main stem bronchus Normal dimension of main bronchi from chest radiograph Paul and Juhl's Essentials of Radiologic Imaging
  4. 4. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 4 AnatomyAnatomy chestradiology.net Clinical anatomy 11 ed 2006
  5. 5. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 5 Cause of BronchiectasisCause of Bronchiectasis Broncholith Retraction of parenchyma (fibrosis) Obstruction by foreign body Neoplastic obstruction Cartilage deficiency (Williams-Campbell syndrome) Cilia syndrome (Kartagener syndrome) Host defenses down (agammaglobulinemia) Infection Emphysema Cystic fibrosis Chronic granulomatous disease Tuberculosis Allergic bronchopulmonary aspergillosis Swyer-James syndrome Inhalation injury (ammonia, gastric acid) Sarcoidosis (uncommon) Chest Radiology: The Essentials, 2nd Edition, Collins, Jannette; Stern, Eric J Mechanisme : 1.Bronchial Obstruction : carcinoma, broncholithiasis, extensive compression, etc. 2.Bronchial wall injury, ex ; cystic fibrosis, Childhood viral and bacterial infection, etc. 3.Parenchymal fibrosis (Traction ) : TB, sarcoidosis, idiopathic pulmonary fibrosis Grainger & Allison's Diagnostic Radiology, 5th ed
  6. 6. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 6 Category and typesCategory and types mildest Most severe A–Z of Chest Radiology
  7. 7. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 7 DiagnosisDiagnosis http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  8. 8. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 8 Radiologic FeaturesRadiologic Features Type Feature CXR cylindric Linear lucencies and parallel markings radiating from the hila (tram tracking), smooth unformly dilated varicose Dilated bronchi, non-uniform dilatation cystic Clustered cysts, non-uniform dilatation,has ulceration with bronchial neovascularisation, sometimes with air fluid level CT cylindric parallel tram track lines or may have a signet-ring appearance composed of a dilated bronchus cut in a horizontal section with an adjacent pulmonary artery representing the stone Varicose irregular or beaded bronchi, with alternating areas of dilatation and constriction cystic large cystic spaces and a honeycomb appearance, http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  9. 9. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 9 Radiologic Figure CXR vs CTRadiologic Figure CXR vs CT Gambarcxr 1. Sylindric Cylindric 1. cystic Gmbarct http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa Sutton WHO Manual Chest Radiology: The Essentials, 2nd Edition, Collins, Jannette; Stern, Eric J CysticVaricose
  10. 10. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 10 CXR of Cystic BronchiectasisCXR of Cystic Bronchiectasis The WHO manual of diagnostic imagingRSUD BANTUL
  11. 11. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 11 Differential DiagnosisDifferential Diagnosis No Signs Modality DD 1. Honey comb appearance CXR and CT Bronchiectasis, advanced pumonary fibrosis 2. Cyst CT Cystic bronchiectasis, bullous emphysema
  12. 12. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 12 ResumeResume • Introduction • Anatomy • Cause and Mechanisme Bronchiectasis • Category and Type • Diagnosis • Radiologic feature • Radiologic Figure • Cystic bronchiectasis • Differensial Diagnosis
  13. 13. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 13 QuizQuiz 31-year-old man is admitted with increasing cough, fever, and sputum production. He gives a history of repeated infections and “pneumonias” since childhood. Routine labs are normal except for a polymorphonuclear leukocytosis. Chest radiograph is shown beside 1. Please describe the picture! 2. What is the most likely diagnosis?
  14. 14. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 14 Terimakasih dan Mohon AsupanTerimakasih dan Mohon Asupan
  15. 15. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 15 Ct cylindric Cylindrical bronchiectasis with signet-ring appearance. Note that the luminal airway diameter is greater than the diameter of the adjacent vessel. http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  16. 16. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 16 Cxr cylindric and cystic Cystic and cylindrical bronchiectasis of the right lower lobe on a posterior-anterior chest radiograph. http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  17. 17. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 17 Ct varicose Varicose bronchiectasis with alternating areas of bronchial dilatation and constriction. http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  18. 18. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 18 Ct cystic and varicose This CT scan depicts areas of both cystic bronchiectasis and varicose bronchiectasis. http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  19. 19. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 19 Ct cystic sutton
  20. 20. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 20 cystic FIG. 26-8. Extensive cystic disease or cystic bronchiectasis. A: Extensive bilateral inflammatory disease in which some rounded radiolucencies can be outlined. B: Right bronchogram shows extensive bronchiectasis, which is cystic and cylindrical
  21. 21. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 21 CYSTIC Chest Radiology: The Essentials, 2nd Edition, Collins, Jannette; Stern, Eric J
  22. 22. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 22 Cylindric Frontal CXR of a patient with cylindrical bronchiectasis, on the magnified image are ring shadows (white arrows) and tram lines (black arrows), representing dilated bronchi end on and lengthways respectively The WHO manual of diagnostic imaging
  23. 23. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 23 varicose Left image is a frontal CXR of an asthmatic patient with ABPA. Note the patchy consolidation, bronchial wall thickening and bronchial dilatation (white arrows). The right image is an HRCT of the same patient demonstrating the bronchiectasis. The distribution is typically central in the mid and upper zones The WHO manual of diagnostic imaging
  24. 24. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 24 cystic Frontal and lateral CXR of a patient with cyctic bronchiectasis secondary to a childhood infection and confined to the right middle lobe. Note the “cysts” with thin walls (black arrows). The “cysts are either focal dilatation of the bronchi or saccular out-pouchings from the bronchi The WHO manual of diagnostic imaging
  25. 25. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 25
  26. 26. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 26 Mechanisme bronchiectasis • three mechanisms by which the dilatation can develop: • bronchial obstruction, bronchial wall damage, and parenchymal fibrosis ( Table 16.1 ). • In the first two mechanisms, the common factor is the combination of mucus plugging and bacterial colonization. Cytokines and enzymes released by inflammatory cells plus toxins from the bacteria result in a vicious cycle of increasing airway wall damage, mucous retention and bacterial proliferation. • In parenchymal fibrosis, the dilatation of bronchi is caused by maturation and retraction of fibrous tissue located in the parenchyma adjacent to an airway (traction bronchiectasis Grainger & Allison's Diagnostic Radiology, 5th ed
  27. 27. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 27 Pathophysiology • Bronchiectasis is an abnormal dilation of the proximal and medium- sized bronchi (>2 mm in diameter) caused by weakening or destruction of the muscular and elastic components of the bronchial walls. Affected areas may show a variety of changes, including transmural inflammation, edema, scarring, and ulceration, among other findings. Distal lung parenchyma may also be damaged secondary to persistent microbial infection and frequent postobstructive pneumonia. Bronchiectasis can be congenital but is most often acquired http://emedicine.medscape.com/article/296961-overview#aw2aab6b2b1aa
  28. 28. Click here to download this powerpoint template : Brown Floral Background Free Powerpoint Template For more : Templates For Powerpoint Page 28
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