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. 2024 Dec 10;12(12):323.
doi: 10.3390/diseases12120323.

Chest X-Ray Features in 130 Patients with Bronchiectasis

Hikaru Sawada  1   2 , Ryohei Kudoh  1 , Atsushi Yokoyama  1 , Akihiko Hagiwara  1 , Kazufumi Hiramatsu  1 , Jun-Ichi Kadota  1 , Kosaku Komiya  1   3
Affiliations

Chest X-Ray Features in 130 Patients with Bronchiectasis

Hikaru Sawada et al. Diseases. .

Abstract

Background/Objectives: The prevalence of bronchiectasis is increasing globally, and early detection using chest imaging has been encouraged to improve its prognosis. However, the sensitivity of a chest X-ray as a screening tool remains unclear. This study examined the chest X-ray features predictive of bronchiectasis. Methods: We retrospectively reviewed the chest X-rays of patients with bronchiectasis diagnosed using high-resolution computed tomography who visited our institute from January 2013 to March 2020. Patients with cardiac pacemakers, lung cancer, and interstitial pneumonia, which might bias the detection of bronchiectasis, were excluded. Two respiratory physicians independently determined the presence or absence of potential features reflecting bronchiectasis, including a vague cardiac silhouette on chest X-rays. Results: The study enrolled 130 patients, including 72 women (55.4%), with a mean age of 72 years. The features observed on chest X-rays included granular shadows (88.5%, n = 115), vague cardiac silhouettes (48.5%, n = 64), nodular shadows (45.4%, n = 59), a tram-track appearance (35.4%, n = 46), pleural thickening (26.9%, n = 35), vague diaphragm silhouettes (25.4%, n = 33), and a ring sign (24.6%, n = 32). The kappa values for these features were 0.271, 0.344, 0.646, 0.256, 0.312, 0.514, and 0.376, respectively. Conclusions: Although traditional chest X-ray features believed to reflect bronchiectasis, such as the tram-track appearance or ring sign, were not frequently seen, vague cardiac silhouettes and granular shadows had high positivity rates, indicating their potential utility for bronchiectasis screening. However, the interobserver concordance rates were unsatisfactory.

Keywords: bronchiectasis; nontuberculous mycobacterium; pneumonia; postinfection.

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Conflict of interest statement

All authors have explicitly stated that they have no conflicts of interest in connection with this article.

Figures

Figure 1
Figure 1
Granular shadow on chest X-ray (A) and high-resolution computed tomography (B). White arrows indicate the same lesions within the patient. Nodular shadow on chest X-ray (C) and high-resolution computed tomography (D). Black arrows indicate the same lesions within the patient.
Figure 2
Figure 2
Vague cardiac silhouette on chest X-ray (A) and high-resolution computed tomography (B). White arrows indicate the same lesions within the patient. Vague diaphragm on chest X-ray (A) and high-resolution computed tomography (C). Black arrows indicate the same lesions within the patient.
Figure 3
Figure 3
Tram-track appearance on chest X-ray (A) and high-resolution computed tomography (B). White arrows indicate the same lesions within the patient. Ring sign on chest X-ray (C) and high-resolution computed tomography (D). Black arrows indicate the same lesions within the patient.
Figure 4
Figure 4
Pleural thickening on chest X-ray (A) and high-resolution computed tomography (B). White arrows indicate the same lesions within the patient.
See this image and copyright information in PMC

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