HRCT patterns in obstructive airway diseases: Pearls and pitfalls

Mohammad Hanafiah Kreah
Sunway Medical Centre, Subang Jaya, Selangor, Malaysia

Obstructive Airway Disease refers to a group of conditions that cause obstruction to the flow of air within the lungs, resulting in increased resistance to air flow within the airways. HRCT is crucial in diagnosing and evaluating certain obstructive airway diseases. Bronchial wall thickening, bronchiectasis, mosaic perfusion and mucous plugging are among the important imaging features to look for and to evaluate when present. Mosaic perfusion refers to areas of differing attenuation in lung parenchyma which can be seen in both disease state and normal individuals (mild). Additional expiratory scan may be necessary demonstrate the presence of air trapping that may suggest an underlying airway disease. Understanding of HRCT appearances of several diseases/conditions such as COPD, asthma, bronchiolitis obliterans is imperative in disease management. While typical or atypical features are demonstrated, awareness of any potential pitfalls is crucial to prevent misinterpretation.