1. Representative computed tomography (CT) and magnetic resonance imaging (MRI) images showing small airways abnormalities. a) Axial CT image in a 45-yr-old smoker showing areas of low attenuation (arrows) related to early centrilobular emphysema. b) Coronal m...
Representative computed tomography (CT) and magnetic resonance imaging (MRI) images showing small airways abnormalities. a) Axial CT image in a 45-yr-old smoker showing areas of low attenuation (arrows) related to early centrilobular emphysema. b) Coronal minimum intensity projection (minIP) image (5 mm thick) in the same subject showing the same lesions with a better conspicuity (arrows). c) Axial CT image in a 56-yr-old smoker with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage III chronic obstructive pulmonary disease (COPD). Small airways findings are seen as multiple small micronodules, with some of them showing a typical branched (tree-in-bud) pattern (arrows). Dilated bronchiolectases (arrowheads) are present in the right lower lobe. d) Coronal minIP inspiratory image (5 mm thickness) of a 63-yr-old smoker with GOLD stage III COPD showing multiple areas of hypoattenuation of various size throughout the lung consistent with a mosaic pattern. There is no visual mean for separating emphysema from hypoattenuation areas related to small airways involvement. e) Axial CT image of a 52-yr-old smoker with GOLD stage II COPD showing areas of hypoattenuation in both the upper segments of the lower lobes (#) and thickened large airways (arrows). f) Coronal MRI images after inhalation of hyperpolarised 3He in a 42-yr-old COPD subject showing the heterogeneous distribution of gas within airspaces. Peripheral areas of hypointensity (arrows) are probably related to emphysema or areas of obstructed small airways. (MRI images provided by Y. Cremilleux, Universitie de Lyon, Lyon, France; personal communication).
P-R. Burgel et al. Eur Respir Rev 2011;20:
©2011 by European Respiratory Society