Correlation of CT findings with clinical evaluations in 261 patients with symptomatic bronchiectasis

OBJECTIVE. In a multicenter study, we evaluated the relationships between t he extent and severity of bronchiectasis on CT and clinical symptoms, spiro metric abnormality, and sputum characteristics. SUBJECTS AND METHODS, The study population included 261 patients with sympt omatic, physiologically significant bronchiectasis, who were enrolled in an other study evaluating the clinical efficacy of deoxyribonudease in treatme nt of bronchiectasis, Patients with cystic fibrosis, allergic bronchopulmon ary aspergillosis, and fungal or mycobacterial infection were excluded. In addition to high-resolution CT scanning, all patients underwent clinical ev aluation, spirometry, and sputum culture. CT features scored by consensus o f two observers included the extent of bronchiectasis, type of bronchiectas is (cylindric, varicose, or cystic), extent of mucoid impaction, and degree of bronchial wall thickening. \ RESULTS. Scores for the severity and extent of bronchiectasis correlated wi th the forced expiratory volume in 1 sec (FEV1) (r = -.362, p < .0001) and with the forced vital capacity (FVC) (r = -.362, p < .0001). Scores for bro nchial wall thickening correlated with the FEV1 (r = -.367, p < .0001) and FVC (r = -.239, p < .001). Patients with cystic bronchiectasis were signifi cantly more likely to grow Pseudomonas from their sputa and to have purulen t sputa than were patients with cylindric or varicose bronchiectasis. Patie nts with cystic bronchiectasis had significantly lower FEV1 and FVC values than did patients with cylindric or varicose bronchiectasis. CONCLUSION. In this patient population, we found weak but significant corre lations between the degree of morphologic abnormality on CT and the extent of physiologic impairment. Cystic bronchiectasis was associated with sputum purulence and with the growth of Pseudomonas. CT classification of the typ e of bronchiectasis may be useful as an index of severity of disease.