Imaging

ABPA

Allergic bronchopulmonary aspergillosis

• Exaggerated response to aspergillus
• Most commonly with Asthma or CF
  • Spores are commonly found in soil and even the sputum of healthy individuals
• Airway inflammation leads to bronchiectasis and, if not treated, it can lead to significant scarring

So, how do we diagnose this disease?

It's not entirely agreed upon

• Chest X-rays 
• CT scans
• IgE and eosinophils
• Immunological tests for Aspergillus 
  • with staining and sputum cultures 

Treatment, however, is

• Steroids
• Antifungal medications

Imaging modalities

• Chest Xray
• CT

X-Ray

• If early, there may be no signs of infection on CXR
• Classically, there is consolidation and mucoid impaction
• Some notable signs include
  • Finger-in-glove opacities
  • "Toothpaste shadows"

CT

• Fleeting alveolar opacities
• Centrilobular nodules
• High attenuation in impacted mucous
• Bronchial wall thickening

Finger in glove

Cylindrical