Allergic Bronchopulmonary Aspergillosis (ABPA)-The High Resolution Computed Tomography (HRCT) Chest Imaging Scenario.

INTRODUCTION: Allergic bronchopulmonary aspergillosis (ABPA) is a progressive disease which can lead to recurrent exacerbations, bronchiectatic changes and end-stage fibrosis. Early diagnosis and treatment prevents its progression and alleviate its clinical manifestations. High resolution CT of the chest has emerged as a promising investigation for its diagnosis.

AIMS AND OBJECTIVES: To review the high resolution computed tomography (HRCT) chest manifestations in ABPA patients.

MATERIALS AND METHODS: This study included 110 patients with ABPA who had undergone HRCT of the chest in the routine diagnostic workup for ABPA. The scans were assessed for changes in bronchi, parenchyma and pleura and findings consistent with ABPA were evaluated.

RESULTS: HRCT chest was normal in 24 patients. 86 patients demonstrated central bronchiectasis with predilection for upper and middle lobes. Centrilobular nodules with or without linear opacities (tree in bud pattern), mucoceles and high-attenuation mucus were seen in 86%, 59% and 36% patients respectively.

CONCLUSION: Central bonchiectasis combined with centrilobular nodules and mucus impaction (especially high attenuation mucus) strongly favour the diagnosis of ABPA.