Traction Bronchiectasis on HRCT | IPF Radiology Rounds

Traction Bronchiectasis

Bronchiectasis is irreversible dilation of the bronchi resulting from airway damage due to a variety of causes, including infection, airway obstruction, or fibrosis.⁷ By definition, traction bronchiectasis results from fibrotic tissue “pulling” on the bronchi, while freestanding bronchiectasis is unrelated to fibrosis.⁷ Traction bronchiectasis is often seen at the periphery of the lung where there is less supportive connective tissue, leaving the bronchi prone to distortion.¹⁰ Peripheral, lower-lobe predominant traction bronchiectasis in the setting of changes consistent with fibrosis is highly suggestive of IPF.^5,45

Honeycombing

Volume Loss

Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

Reference

5. Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788-824.

7. Hansell DM, Bankier AA, MacMahon H, et al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246:697-722.

10. Jacob J, Hansell DM. HRCT of fibrosing lung disease. Respirology. 2015;20:859-872.

45. Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198(5):e44-e68.