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High attenuation mucus impaction in patients with allergic bronchopulmonary aspergillosis: Objective criteria on high resolution computed tomography and correlation with serological parameters
3rd International Conference on Radiology and Imaging
Mandeep Kumar Garg
Postgraduate Institute of Medical Education and Research, India
Aims & Objectives: The purpose of this prospective study was to correlate the high resolution computed tomography (HRCT)
finding of mucoid impaction including high attenuation mucus (HAM) impaction, with immunological parameters in patients with
allergic bronchopulmonary aspergillosis (ABPA) and to propose objective criteria for HAM.
Materials & Methods: The institutional Review Board approved the study and informed written consent was obtained from all
patients. One hundred consecutive patients diagnosed as ABPA between June 2012 and December 2013 undergoing HRCT chest
were enrolled. Each HRCT chest was evaluated for central bronchiectasis, mucoid impaction and the number of affected bronchial
segments. CT attenuation values and mean CT density of mucoid impaction were calculated; and based on that patients were classified
into HAM and Non-HAM group. Immunological severity of the disease was assessed in terms of total IgE, specific IgE and absolute
eosinophil count.
Results: Patients of ABPA with HAM impaction on HRCT were found to have significantly higher levels of total IgE (P<0.001),
specific IgE (P=0.03) and number of bronchial segments affected (P<0.001) compared to non-HAM group. We found CT density
of 70 Hounsefield Units (HU) as an adequate cut-off value for HAM impaction and CT value of >100 HU correlated well with
immunological severity in ABPA.
Conclusion: There is a statistically significant relationship between absolute CT values of HAM impaction on HRCT and
immunological severity in ABPA.