Distribution and severity of bronchiectasis in allergic bronchopulmonary aspergillosis (ABPA)

The purpose of this paper was to quantitate the distribution and severity o f computed tomography (CT) and radiographic findings in patients with aller gic bronchopulmonary aspergillosis (ABPA), probable ABPA, and asthmatic con trols. Chest radiographs and high-resolution CT images were evaluated in 19 patients with documented ABPA and 18 asthmatic controls. Ten patients with probable ABPA were also evaluated. On CT examination 17 patients (89%) wit h ABPA had central cystic or varicoid bronchiectasis in at least one lobe. One patient had no evidence for bronchiectasis. The asthmatic patients (17% ) had findings of cylindrical bronchiectasis, All 10 patients with probable ABPA had evidence of bionchiectasis on high-resolution CT (HRCT). The majo rity of patients with ABPA have diffuse disease at the time of diagnosis, m anifested by central cystic and/or varicoid bronchiectasis in four or five lobes. Evaluation with HRCT can facilitate a diagnosis of ABPA and probable ABPA, allowing for earlier treatment which may prevent progression to fibr osis.