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

[allergic bronchopulmonary aspergillosis]

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 .To review the high resolution computed tomography (HRCT ) chest manifestations in ABPA patients .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 .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 .Central bonchiectasis combined with centrilobular nodules and mucus impaction (especially high attenuation mucus ) strongly favour the diagnosis of ABPA .