Chest radiographic and computed tomographic manifestations in allergic bronchopulmonary aspergillosis

Table 1 Baseline characteristics of 60 patients with allergic bronchopulmonary aspergillosis n (%)

Demographic details
Age (yr), median (IQR)	30 (21.3-43.5)
Sex (M:F)	34:26
History
Duration of asthma (yr), median (IQR)	6.5 (3-10.75)
Hemoptysis	20 (33.3)
Expectoration of brownish-black mucus plugs	23 (38.3)
Prescription of anti-tuberculous therapy	17 (28.3)
Tobacco smoking	3 (5)
Spirometry
Normal	14 (23.3)
Mild obstruction	15 (25)
Moderate obstruction	19 (31.7)
Severe obstruction	12 (20)
Bronchodilator reversibility	29 (48.3)
Immunological findings
Aspergillus skin test
Type 1	60 (100)
Type 3	47 (78.3)
Absolute eosinophil count (/μL), median (IQR)	800 (485-1535)
Aspergillus precipitins	50 (83.3)
IgE levels (total) (IU/mL), median (IQR)	6068.5 (3041-10284)
IgE levels (Af) (kU/L), median (IQR)	6.5 (1.31-23.23)

Table 2 Radiographic findings in the first chest radiograph in 60 cases of allergic bronchopulmonary aspergillosis

Normal	30
Transient
Fleeting opacities	24
Toothpaste/finger-in-glove opacities	23
Consolidation	17
Nodular	13
Atelectasis	8
Fixed
Parallel line and ring shadows	251
Cystic bronchiectasis	10

¹Includes tramline shadows.

Table 3 High resolution computed tomography findings in 60 consecutive patients with allergic bronchopulmonary aspergillosis n (%)

	Results
Staging of ABPA
ABPA-S	22 (36.7)
ABPA-CB	25 (41.7)
ABPA-CB-HAM	13 (21.7)
Lobar and segmental involvement by bronchiectasis (n = 38), median (IQR)
Number of lobes	4 (3-5)
Number of segments	7 (4-9)
No. of lobes/segments not evaluable	8/20
No. of lobes/segments affected by central bronchiectasis	139/182
No. of lobes affected by peripheral bronchiectasis
By 1/2 criteria	60/139 (43.2%)
By 2/3 criteria	46/139 (33.1%)
Right upper lobe	33/38
Apical segment	14
Anterior segment	19
Posterior segment	25
Right middle lobe	23/38
Medial segment	21
Lateral segment	13
Right lower lobe	27/38
Apical	20
Medial	10
Anterior	12
Lateral	15
Posterior	14
Left upper lobe	27/38
Apicoposterior	17
Anterior	17
Superior lingular	15
Inferior lingular	9
Left lower lobe	29/38
Apical	19
Anterior	12
Lateral	12
Posterior	18
Other findings
Centrilobular nodules and tree-in-bud opacities	28 (46.7)
Atelectasis	8 (13.3)
Mucoid impaction	30 (50)
Mosaic attenuation	12 (20)
High-attenuation mucus	13 (21.7)
Lower lobe involvement without upper lobe involvement	3 (5)

ABPA: Allergic bronchopulmonary aspergillosis; CB: Central bronchiectasis; HAM: High attenuation mucus.

Table 4 Studies describing high resolution computed tomography findings in patients with allergic bronchopulmonary aspergillosis

Author (yr)	No. of patients	HRCT thickness	Scan time (s)	Window width/level	Lobes or segments evaluated	Central bronchiectasis criteria	Patients with CB	Patients with PB	Lobes with CB/PB	Lobes with PB
Currie et al[13] (1987)	9	3mm every 10 mm	5.5	Wide setting	NA	Subjective; based on proximity to hilum	9	7	31	19
Neeld et al[14] (1990)	8	1.5 mm every 10 or 20 mm		2000/-550	46 lobes	Medial 2/3rd of the lung	6	2	19	2
Shah et al[15] (1992)	2	NA	4.0	1000/-700	37 segments	Medial 2/3rd of the lung	24 segments	None		None
Angus et al[16] (1994)	14	3 mm every 9 mm	9.5	NA	102 lobes	Medial 2/3rd of the lung	14	1	43	5
Panchal et al[17] (1994)	21	8 mm contiguous sections	3-5	NA	336 segments	Medial 2/3rd of the lung	NA	NA	212 segments	NA
Sandhu et al[18] (1994)	15	8 mm contiguous scans (2-4 mm where required)	NA	1000/-700	90 lobes	Medial 2/3rd of the lung	44	NA	57	18
Panchal et al[19] (1997)	23	8 mm contiguous (4 mm if not clearly visualized)	3-5	NA	134 lobes/406 segments	Medial 2/3rd of the lung	23	NA	114 lobes 210 segments	34 lobes 45 segments
Ward et al[20] (1999)	44	1-3 mm every 10 mm at 5 selected levels	NA	NA	264	Medial 2/3rd of the lung	28	NA	184	NA
Mitchell et al[21] (2000)	19	1-1.5 mm every 10-20 mm; 5 and 10 mm contiguous cuts also taken	1-2	NA	114	Medial 2/3rd of the lung	18	15	101	NA
Agarwal et al[22] (2006)	126	1.25 mm every 10 mm	3.0	1500/-600	431 lobes/1621 segments	Medial half of the lung midway between the hilum and chest wall	NA	NA	255 lobes/664 segments	99 lobes

HRCT: High resolution computed tomography; CB: Central bronchiectasis.