Bronchiectasis is the irreversible dilatation of the airways. There are different types including cylindrical, varicose, and cystic bronchiectasis. CT scans are useful for diagnosis and can show signs like the signet ring sign, lack of bronchial tapering, and visibility of peripheral airways. Pseudo-bronchiectasis can occur due to artifacts or conditions like tumors, broncholithiasis, or post-irradiation fibrosis. Common causes of diffuse bronchiectasis include cystic fibrosis, sarcoidosis, nontuberculous mycobacterial infections, and immotile cilia syndrome. Idiopathic bronchiectasis and recurrent childhood infections are common

1. Bronchiectasis
Dr / Hytham Nafady

2. Definition
• Irreversible dilatation of the cartilage
containing airways.

4. Bronchial tree

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

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).

33. Endobronchial tumor
(carcinoid)

34. Broncholithiasis

35. Bronchial atresia

36. Bronchial stenosis

37. Post-irradiation fibrosis
(traction bronchiectasis)

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.

54. Atlas of bronchiectasis

56. Bronchietasis
Lack of bronchial
tapering
+
Tree in bud
opacities

58. LUL bronchiectasis

60. RML bronchiectasis