Radiological abnormalities associated with Aspergillus colonization in a cystic fibrosis population

Eur J Radiol. 2012 Mar;81(3):e197-202. doi: 10.1016/j.ejrad.2011.01.114. Epub 2011 Feb 23.


Objective: To determine if sputum colonization with Aspergillus species in patients with cystic fibrosis (PWCF) correlates with radiological abnormalities and/or a reduction in pulmonary function (FEV1).

Methods: We prospectively evaluated 32 PWCF utilizing high resolution computed tomography (HRCT) of the thorax and pulmonary function testing (PFT). The cohort was assessed as two groups: Aspergillus positive (n=16) and Aspergillus negative (n=16) based on sputum culture for Aspergillus species. A modified Bhalla scoring system was applied to each HRCT scan by two blinded radiologists.

Results: Aspergillus positive patients had more severe and significant bronchiectasis compared to those Aspergillus negative (p<0.05). This was most marked in the right upper and lower lobes (RUL, RLL). Total Bhalla score was clinically significant in both groups and approached statistical significance between groups (p=0.063). No difference in pulmonary function between the groups was detected.

Conclusion: PWCF colonized by Aspergillus species have greater radiological abnormalities undetectable by PFTs. Early radiological evaluation of Aspergillus colonized PWCF is therefore warranted.

MeSH terms

  • Adolescent
  • Aspergillosis / diagnostic imaging*
  • Aspergillosis / physiopathology*
  • Bronchiectasis / diagnostic imaging*
  • Bronchiectasis / microbiology
  • Bronchiectasis / physiopathology*
  • Child
  • Cystic Fibrosis / diagnostic imaging*
  • Cystic Fibrosis / physiopathology*
  • Humans
  • Prospective Studies
  • Respiratory Function Tests
  • Severity of Illness Index
  • Sputum / microbiology
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*
  • Young Adult