Bronchiectasis

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Bronchiectasis

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

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