PURPOSE: To determine if there is a correlation between anatomic involvement seen on the CT scan and functional limitation on PFTs and to define the lung function abnormalities seen in patients with Bronchiectasis.
METHODS: Chest CT scan and PFT data were collected on 64 patients after IRB approval. The pattern seen on CT scan was classified as local if there was a segmental or lobar involvement and diffuses if more than one lobe was involved.
RESULTS: Thirty three patients had diffuse bronchiectasis whereas 30 were with localized disease. Twenty six patients (42%) had normal PFT, 19(30%) showed an obstructive defect, 16(25%) patients showed a restrictive defect and 2(3%)had obstructive and restrictive pattern. The DLCO was found to be low in 35 (76%) patients who had the test and normal in 13 (24%) patients. 13(37%) of the patients has normal spirometry and low DLCO. Of the patients with diffuse bronchiectasis 12 (36%) had an obstructive disease, 9 (28%) showed a restrictive defect and 12 (36%) patients had a normal spirometry. Amongst the patients with diffuse bronchiectasis DLCO was low in 16 (69%) patients and amongst those who had a normal spirometry 8(34%) patients had a low DLCO. Of the patients with localized bronchiectasis 7 (23%) showed an obstructive defect, 7 (23%) had a restrictive defect and 15 ( 50%) were with a normal spirometry. The DLCO was low in 76% of patients with localized disease and abnormal spirometry and in 24% of the patients with normal spirometry.
CONCLUSION: 1-Restrictive defect was seen as commonly as obstructive pattern in patients with bronchiectasis. 2-The severity of the bronchiectasis on the CT chest did not correlate with the spirometry findings.3-One third of the patients with normal spirometry also demonstrated a low DLCO which suggests that an isolated reduction of DLCO may be seen in patients with bronchiectasis.
CLINICAL IMPLICATIONS: Further studies are needed to define the mechanisms to understand the diffusion abnormalities in patients with bronchiectasis.
DISCLOSURE: Dana Rifai, No Financial Disclosure Information; No Product/Research Disclosure Information