Learning objectives
To review direct and indirect radiological findings in small airway disease and its anatomical,
semiological and pathological correlation.
To remember the bronchiolar classification of bronchiolitis that includes the wide range of pathologies that manifest themselves as small airway disease and can be easily applied in everyday practice.
Background
Bronchioles are small airways that do not contain cartilage in their walls located at the center of the secondary pulmonary lobule,
has an internal diameter less of 2 mm,
therefore,
they are not visible when are normal.
The thickening of its walls and the variable intraluminal exudate reflecting an inflammatory process or fibrosis named bronchiolitis,
term that encompasses a broad number of diseases [1,
2]
Bronchiolitis or small airway disease is a radiological finding very frequent in daily practice that requires an adequate anatomical knowledge...
Findings and procedure details
We performed a retrospective search of patients with radiologic manifestations compatible with bronchiolitis,
selecting the most representative cases,
most of them with pathological correlation
BRONCHIOLAR CLASSIFICATION
The bronchiolar classification of bronchiolitis classify the bronchiolar disorders into primary with the affectation of the bronchiole and another disease with secondarily involved in the bronchiole.
(Figure 7)
PRIMARY BRONCHIOLAR DISORDERS
Constrictive bronchiolitis
Also known as obliterative bronchiolitis is characterized histologically by peribronchiolar fibrosis secondary of a chronic inflammation and submucosal scarring with resulting bronchiolar narrowing and air trapping....
Conclusion
The previous knowledge of anatomy in high-resolution CT and its semiological correlation are necessary so that the radiologist can identify and understand direct and indirect signs present in small airway disease.
Its classification etiologic and patient clinical data are key to decrease the differential diagnoses in this wide spectrum of pathologies.
Personal information
Dra Aura Lucia Rivera,
Department of radiology.
University Hospital Mayor- Mederi.
[email protected]
Dra Karen Natalia Nieto,
Radiology Resident; Fundación Universitaria Sanitas- Bogotá/ Colombia.
[email protected]
Dra Andrea cera,
general doctor; Universidad del Rosario- Bogotá/Colombia.
[email protected]
References
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Imaging of Small Airways Diseases.
Radiologic Clinics of North America 54 (2016) 1165–1181.
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Bronchiolitis.
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Müller N.L,
Naidich D,
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Normal lung anatomy.
High-Resolution CT of the lung (2015) 111-162.
Pipavath S,
N.J & Stern E.J.
Imaging of Small Airways Disease (SAD).
Radiologic Clinics of North America 47 (2009) 307–316.
Webb W.R,
Müller N.L,
Naidich D,
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Multiple nodules and nodular opacities.
High-Resolution CT of the lung (2015)...