CT-interpretation

Posted by bsi15 @bsi15, Aug 2 8:14am

where to get a bronchiectasis-specific interpretation of my thorax-CT ?

number of bronchiectases , which lobes are affected ,
which of the multiple .jpg images show it

Which type of bronchiectasis (cylindrical,varicose,cystic)

How are they identified (
bronchoarterial ratio,
no peripheral reduction of bronchussize,
bronchus visible near the pleura )

Interested in more discussions like this? Go to the MAC & Bronchiectasis Support Group.

Normally the scan is interpreted and reported on at the time.

REPLY

@bsi15 Hello, the radiologist reports your CT results to the ordering physician, who interprets the results based on your condition and other symptoms, then reaches a diagnosis and formulates a treatment plan. If the ordering physician is not a pulmonologist, they will often refer you to one for the diagnosis and treatment.

Has the ordering physician discussed next steps with youy? If not, perhaps a call to their office is in order at this point.
Sue

REPLY
@sueinmn

@bsi15 Hello, the radiologist reports your CT results to the ordering physician, who interprets the results based on your condition and other symptoms, then reaches a diagnosis and formulates a treatment plan. If the ordering physician is not a pulmonologist, they will often refer you to one for the diagnosis and treatment.

Has the ordering physician discussed next steps with youy? If not, perhaps a call to their office is in order at this point.
Sue

Jump to this post

Once bronchietasis is confirmed on xray by a radiologist, the next step is to see a pulmonologist who should interpret findings.
Good luck!

REPLY

there was no ordering physician. It was a surprising find
in hospital after pneumonia.
The radiologist reports extensive BEs on both sides,
besides other problems.
Several sites offer radiological 2nd opinions
on Thorax-CT
(i.e. NDI in USA)
but I found none that are specific to BE and
available by telemedine

For the EMBARC-study they also list the
radiologic "Reiff-score" for radiological severity

REPLY
@bsi15

there was no ordering physician. It was a surprising find
in hospital after pneumonia.
The radiologist reports extensive BEs on both sides,
besides other problems.
Several sites offer radiological 2nd opinions
on Thorax-CT
(i.e. NDI in USA)
but I found none that are specific to BE and
available by telemedine

For the EMBARC-study they also list the
radiologic "Reiff-score" for radiological severity

Jump to this post

Okay, so this was an "incidental finding" while you were hospitalized - this is a fairly common way for Bronchiectasis to be discovered - especially in conjunction with pneumonia. The hospital should have recommended a follow-up plan. I think @mariegrace is right - "extensive BE" requires a consult with a pulmonologist, not a radiological second opinion.
Have you contacted a pulmonologist yet?

REPLY
@sueinmn

Okay, so this was an "incidental finding" while you were hospitalized - this is a fairly common way for Bronchiectasis to be discovered - especially in conjunction with pneumonia. The hospital should have recommended a follow-up plan. I think @mariegrace is right - "extensive BE" requires a consult with a pulmonologist, not a radiological second opinion.
Have you contacted a pulmonologist yet?

Jump to this post

no, pulmologists appointments are difficult to get here
and there is none who is specialized in bronchiectasis.
So I searched the web instead and found all the guidelines
and papers.
I'd like to know who here knows their BE-types,
Reiff score , lobes affected etc..
Nothing with keyword-search

REPLY
@bsi15

no, pulmologists appointments are difficult to get here
and there is none who is specialized in bronchiectasis.
So I searched the web instead and found all the guidelines
and papers.
I'd like to know who here knows their BE-types,
Reiff score , lobes affected etc..
Nothing with keyword-search

Jump to this post

Are you located outside of the US? If not, there are many options for finding pulmonology care, including facilities like Mayo Clinic, National Jewish Health and University of Texas at Tyler, among others.

Knowing the type of bronchiectasis, without a complete evaluation of other factors such as cough, fatigue, infection status and overall health, does not indicate the severity of your condition.

Please read read what this study says about relying on the Reiff score:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092240/
Specifically, they caution: "The Reiff score, based on subjective evaluation of bronchiectasis features, fails to capture the diversity of the disease. It has the potential to assign high scores to patients with localized but severe abnormalities while neglecting those with widespread yet less pronounced structural..."

Even seeing a pulmonologist unfamiliar with bronchiectasis is better than trying to self-diagnose. They would have access to colleagues and resources to help them evaluate your overall condition and recommend next steps.

REPLY
@bsi15

no, pulmologists appointments are difficult to get here
and there is none who is specialized in bronchiectasis.
So I searched the web instead and found all the guidelines
and papers.
I'd like to know who here knows their BE-types,
Reiff score , lobes affected etc..
Nothing with keyword-search

Jump to this post

Your primary care provider should refer you to a pulmonologist bsi15.
Where do you live?? There are specialists at NYU and NYP Cornell and Columbia Presbyterien.
Maybe Mayo clinic can recommend one in your area.
Good luck!

REPLY
@sueinmn

Are you located outside of the US? If not, there are many options for finding pulmonology care, including facilities like Mayo Clinic, National Jewish Health and University of Texas at Tyler, among others.

Knowing the type of bronchiectasis, without a complete evaluation of other factors such as cough, fatigue, infection status and overall health, does not indicate the severity of your condition.

Please read read what this study says about relying on the Reiff score:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092240/
Specifically, they caution: "The Reiff score, based on subjective evaluation of bronchiectasis features, fails to capture the diversity of the disease. It has the potential to assign high scores to patients with localized but severe abnormalities while neglecting those with widespread yet less pronounced structural..."

Even seeing a pulmonologist unfamiliar with bronchiectasis is better than trying to self-diagnose. They would have access to colleagues and resources to help them evaluate your overall condition and recommend next steps.

Jump to this post

thanks for the link. I just only read the abstract. They do see a good correlation
of Reiff-score and disease severity. So its useful to ask for your Reiff score.
I was mostly relying to the BSI-index, which seems to be the best predictor.
I get an estimated 15 , see my screen-name here.
I found my life expectancy reduced from 15 to 5 years, that's
why I'm here ....
But I feel a bit lost here.
Atypical.
No MAC, no asthma, no COPD, no airway clearing
But breathlessness and lots of mucous in the afternoon,evening,night
which strangely improved a lot some days ago, maybe by diet..

I sent email to the main German Bronchiectase Center , MHH - no reply.
And now I just get a reply from U of Freiburg
that they only advice foreigners, no Germans.
Strange. Must be the German telemedicine-laws

REPLY
@bsi15

thanks for the link. I just only read the abstract. They do see a good correlation
of Reiff-score and disease severity. So its useful to ask for your Reiff score.
I was mostly relying to the BSI-index, which seems to be the best predictor.
I get an estimated 15 , see my screen-name here.
I found my life expectancy reduced from 15 to 5 years, that's
why I'm here ....
But I feel a bit lost here.
Atypical.
No MAC, no asthma, no COPD, no airway clearing
But breathlessness and lots of mucous in the afternoon,evening,night
which strangely improved a lot some days ago, maybe by diet..

I sent email to the main German Bronchiectase Center , MHH - no reply.
And now I just get a reply from U of Freiburg
that they only advice foreigners, no Germans.
Strange. Must be the German telemedicine-laws

Jump to this post

It appears the German Brochiectasis Center, MHH is no different than many health facilities. The facilities do not reply as soon as we hope they would. Keep trying with knowing all health facilities, it appears, are overwhelmed. We need to constantly stay on top of it all...and do much calling and follow up ourselves. Most important and fortunate for you is that you had the test and now know there is a problem that needs to be discussed and that you need to find out all that you need to do for yourself. Keep on, keeping on....you will get your information and appointments needed.
Greetings from across the ocean.
Barbara

REPLY
Please sign in or register to post a reply.