Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Imaging of the Small Airway Diseases

소기도 질환의 영상소견

  • Chung, Myung Hee (Department of Radiology, Holy Family Hospital, The Catholic University)
  • 정명희 (가톨릭대학교 방사선과학교실)
  • Published : 2005.08.30
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Abstract

"소기도"라 일컬어지는 해부학적 부위는 말단부 막성 세기관지와 호흡성 세기관지로 구성된 직경 3 mm 이하의 기도부위이다. 방사선학적으로는 고해상 전산화단층촬영(CT)에서 흉막직하의 직경 약 1.0 cm으로 이루어진 2차 소엽내의 중심부에 위치하게 된다. 그러므로 이 부위의 질환때에는 중심소엽성 세기관지내의 가득찬 물질로 인해 나타나는 중심소엽성 결절들과 선상음영들이 보인다. 이외의 소견으로는 중심소엽성 폐기종, 모자이크 모양의 폐음영, 분절하 무기폐등이 있고, 호기시 CT 촬영에서 나타나는 공기포획이 있다. 최근에는 다검출기형식의 CT (multidetector CT)의 발전으로 인하여 이차원 재구성 (2 dimension reformat) 관상면, 시상면 CT 스캔을 매우 명확하고 빨리 얻을 수 있고, 기관지에 대한 삼차원 볼륨 영상 (3 dimentional volume rendering image) 등을 얻어서 가시적인 효과를 높이고 진단의 정확성에 보다 더 접근하게 되었다. 소기도를 침범하는 질환은 일차적인 것과 이차적인 것이 있는데, 병리조직학적으로는 원인별로 흡연으로 인한 소기도 질환, 세포성 세기관지염, 수축성 세기관지염, 증식성 세기관지염등으로 구분하며 여기에는 이와 같은 병리질환을 일으키는 다양한 원인들이 포함된다. 이외에도 드문 질환으로 미만성 범세기관지염, 광물질에 의한 소기도 질환등이 있다.

Keywords

References

  1. Wright JL, Cagle P, Churg A, Colby T, Myers J. Disease of the small airways. Am Rev Respir Dis 1992;146:240-62 https://doi.org/10.1164/ajrccm/146.1.240
  2. Muller NL, Miller RR. Diseases of the bronchioles: CT and histopathologic findings. State of the art review. Radiology 1995;196:3-12 https://doi.org/10.1148/radiology.196.1.7784583
  3. Thurlbeck WM. Smoking: airflow limitation and the pulmonary circulation. Am Rev Respir Dis 1980;122:183-6
  4. Nagai A, West WW, Paul JL. Thurlbeck WM. The National Institutes of Health Intermittent Positive-Pressure Breathing trial: pathology studies. Am Rev Respir Dis 1985;132:937-45
  5. Kuhn C II. Normal anatomy and histology. In Thurlbeck WM, Churg AM, editors. Pathology of the Lung. 2nd ed. New York: Thieme; 1995. p 1-36
  6. Teel GS, Engeler CE, Tashijian JH, duCret RP. Imaging of small airways disease. Radiographics 1996;16:27-41 https://doi.org/10.1148/radiographics.16.1.27
  7. Gruden J, Webb W, Warnock M. Centrilobular opacities in the lung on high-resolution CT: diagnostic considerations and pathologic correlation. Am J Roentgenol 1994;162:569-74 https://doi.org/10.2214/ajr.162.3.8109498
  8. Arakawa H, Webb WR, McCowin M, Katsou G, Lee KN, Seitz RF. Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans. Radiology 1998;206:89-94 https://doi.org/10.1148/radiology.206.1.9423656
  9. Worthy SA, Muller NL, Hartman TE, Swensen SJ, Padley SP, Hansell DM. Mosaic attenuation pattern on thin-section CT scans of the lung: differentiating among infiltrative lung, airway, and vascular diseases as a cause. Radiology 1997;205:465-70 https://doi.org/10.1148/radiology.205.2.9356630
  10. Stern EJ, Swensen SJ, Hartman ET, Frank MS. CT mosaic pattern of lung attenuation: distinguishing different causes. Am J Roentgenol 1995;165:813-6 https://doi.org/10.2214/ajr.165.4.7676972
  11. Tuddenham WJ. Glossary of tems for thoracic radiology: recommendations of the Nomenclature Committee of the Fleischner Society. Am J Roentgenol 1984;143:509-17 https://doi.org/10.2214/ajr.143.3.509
  12. Chen D, Webb WR, Storto ML, Lee KN. Assessment of air trapping using postexpiratory high-resolution computed tomography. J Thoracic Imaging 1998;13:135-43 https://doi.org/10.1097/00005382-199804000-00009
  13. Gotway MB, Lee ES, Reddy GP, Golden JA, Webb WR. Low-dose, dynamic, expiratory thin-section CT of the lungs using a spiral CT scanner. J Thoracic Imaging 2000;15:168-72 https://doi.org/10.1097/00005382-200007000-00003
  14. Lucidarme O, Grenier PA, Cadi M, Mourey-Gerosa I, Benali K, Cluzel P. Evaluation of air trapping at CT: comparison of continuous versus suspended-expiration CT techniques. Radiology 2000;216:768-72 https://doi.org/10.1148/radiology.216.3.r00se21768
  15. Tanaka N. Matsumoto T, Suda H, Miura G, Matsunaga N. Paired inspirator-expiratory thin-section CT findings in patients with small airway disease. Eur. Radiol 2001;11:393-401 https://doi.org/10.1007/s003300000572
  16. Remy-Jardin M, Remy J, Deschildre F, Artaud D, Ramon P, Edme JL. Obstructive lesions of the central airways: evaluation by using spiral CT with multiplanar and three-dimensional reformation. Eur Radiol 1996;6:807-16
  17. Nishino M, Hatabu H. Volumetric expiratory high-resolution CT of the lung. Eur J Radiol 2004;52:180-4 https://doi.org/10.1016/j.ejrad.2003.10.018
  18. Chooi WK, Matthews S, Bull MJ, Morcos SK. Multislice helical CT: the value of multiplanar image reconstruction in assessment of the bronchi and small airways disease. Br J Radiol 2003;76:536-40 https://doi.org/10.1259/bjr/21813112
  19. Worthy SA, Muller NL. Small airway disease. Radiol Clin North Am 1998;36:163-73 https://doi.org/10.1016/S0033-8389(05)70012-9
  20. Mastora I, Remy-Jardin M, Sobaszek A, Boulenguez C, Remy J, Edme JL. Thin-section CT finding in 250 volunteers: assessment of the relationship of CT findings with smoking history and pulmonary function test results. Radiology 2001;218:695-702 https://doi.org/10.1148/radiology.218.3.r01mr08695
  21. Chung MH, Edinburgh KJ, Webb EM, McCowin M, Webb RW. Mixed infiltrative and obstructive disease on high-resolution CT. J Thoracic Imaging 2001;16:69-75 https://doi.org/10.1097/00005382-200104000-00001
  22. Turton CW, Williams G, Green ML. COP in adults. Thorax 1981;36:805-10 https://doi.org/10.1136/thx.36.11.805
  23. Lee ES, Gotway MB, Reddy GP, Golden JA, Keith FM, Webb WR. Early bronchiolitis obliterans following lung transplantation: accuracy of expiratory thin-section CT for diagnosis. Radiology 2000;216: 472-7 https://doi.org/10.1148/radiology.216.2.r00au21472