THE SIGNIFICANCE OF BRONCHIAL DILATATION ON CT IN PATIENTS WITH ADULT-RESPIRATORY-DISTRESS-SYNDROME

Aims: Irreversible bronchial dilatation on computed tomography (CT) is seen in patients with interstitial pulmonary fibrosis whereas reversi ble dilatation of the bronchi is a feature of many conditions, The aim of this study was to determine whether airways dilatation, which is a frequent finding in adult respiratory distress syndrome (ARDS), is re versible and to establish whether persistent airways dilatation is acc ompanied by other CT signs of established interstitial fibrosis, Metho d: Thin section CT scans of 16 patients with ARDS were analysed at a l obar level in the acute phase of the disease and at follow-up (median interval 6.3 months) for the presence and extent of a ground-glass pat tern, reticular or linear opacities and the presence or absence of bro nchial dilatation, Results: 95 out of 96 (99%) lobes on the initial CT scan showed ground-glass pattern, Airway dilatation was present in 65 of 95 (68%) of these lobes, On follow-up CT the airways remained dila ted in 60 of 65 (92%) lobes and, in the majority of these, 53 of 60 (8 8%), a reticular and linear pattern with associated distortion had dev eloped, A coexisting ground-glass pattern was present in 12 of 60 (20% ) lobes on follow-up CT, but was the sole residual abnormality in only one lobe, Conclusion: In patients with ARDS, dilatation of the airway s within areas of ground-glass pattern is a frequent observation in th e acute phase of the condition and tends to persist at follow-up, usua lly accompanied by the CT features of supervening pulmonary fibrosis.