Computed tomography features in patients with non-cystic fibrosis bronchiectasis and COPD – one Institution experience

Introduction:

Non-cystic fibrosis bronchiectasis is a progressive respiratory disease of permanent dilatation of bronchi. Radiologically, they are divided into groups: cylindrical, varicose or cystic. Most commonly used radiological score for evaluation of bronchiectasis is Reiff score (0 – 18) which is believed to have impact on severity and outcome of disease.

Methods:

There was 108 patients in this retrospective study who previously had the diagnosis of non-cystic fibrosis bronchiectasis in their medical data, all hospitalized in our Institution in the past three years. After reviewing their CT/HRCT examinations, 102 patients were involved in this study.

Aim:

It was to evaluate radiological features in these patients with emphasis on correlation with COPD, the Reiff score and emphysema.

Results:

In our study, over two thirds of patients were male (73/102) and 29 female, with the average age of 62 years. Half of patients (53/102) did not have clinical signs of emphysema. From the medical data, patients were categorized in two groups, one who had only bronchiectasis (46 pt), and who had combined bronchiectasis and COPD (56/102 patients). Average number of hospitalizations was 1 (in 67 pts), with the maximum number of 9 in 1 patient. Upon CT/HRCT reviews, we concluded that 63 patients had radiological signs of emphysema, of which 34 had mild emphysema, 20 moderate and 9 severe form. Average Reiff score was 4.78 (23 pt), with the maximum of 17 (in one patient), only three patients had score of 1. Score was higher in group with combined bronchiectasis/COPD (4.98: 4.63).

Conclusion: In patients previously diagnosed with emphysema and bronchiectasis, CT average Reiff score was 4.78, and only three patients had score over 10. More than half of patients had CT signs of emphysema. In correlation, all patients who had 4 or more hospitalizations did not have the average Reiff score over 7.

References:

[1] Chalmers JD, Goeminne P, Aliberti S et al. The bronchiectasis severity index. An international derivation and validation study, (2014) American journal of respiratory and critical care medicine 189 (5), 576 – 585.

[2] Jairam PM, van der Graaf Y, Lammers JW, Mali WP, de Jong PA; PROVIDI Study group. Incidental findings on chest CT imaging are associated with increased COPD exacerbations and mortality. Thorax. 2015 Aug;70(8):725 – 31.