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European Radiology

, Volume 28, Issue 10, pp 4053–4061 | Cite as

The scab-like sign: A CT finding indicative of haemoptysis in patients with chronic pulmonary aspergillosis?

  • Haruka Sato
  • Fumito Okada
  • Shunro Matsumoto
  • Hiromu Mori
  • Junji Kashiwagi
  • Eiji Komatsu
  • Toru Maeda
  • Haruto Nishida
  • Tsutomu Daa
  • Satoshi Ohtani
  • Kenji Umeki
  • Masaru Ando
  • Junichi Kadota
Chest

Abstract

Objectives

The aim of this study was to assess the CT findings that characterise haemoptysis in patients with chronic pulmonary aspergillosis (CPA).

Methods

We retrospectively identified 120 consecutive patients with CPA (84 men and 36 women, 17–89 years of age, mean age 68.4 years) who had undergone a total of 829 CT examinations between January 2007 and February 2017. In the 11 patients who underwent surgical resection, CT images were compared with the pathological results.

Results

The scab-like sign was seen on 142 of the 829 CT scans, specifically, in 87 of the 90 CT scans for haemoptysis and in 55 of the 739 CT scans obtained during therapy evaluation. In 48 of those 55 patients, haemoptysis occurred within 55 days (mean 12.0 days) after the CT scan. In the 687 CT scans with no scab-like sign, there were only three instances of subsequent haemoptysis in the respective patients over the following 6 months. Patients with and without scab-like sign differed significantly in the frequency of haemoptysis occurring after a CT scan (p<0.0001). Pathologically, the scab-like sign corresponded to a fibrinopurulent mass or blood crust.

Conclusions

The scab-like sign should be considered as a CT finding indicative of haemoptysis.

Key Points

• Haemoptysis is commonly found in patients with CPA.

• A CT finding indicative of haemoptysis in CPA patients is described.

• Scab-like sign may identify CPA patients at higher risk of haemoptysis.

Keywords

Helical CT Chest Aspergillosis Haemoptysis Infections 

Abbreviations

CCPA

Chronic cavitary pulmonary aspergillosis

CFPA

Chronic fibrosing pulmonary aspergillosis

CNPA

Chronic necrotising pulmonary aspergillosis

CPA

Chronic pulmonary aspergillosis

CT

Computed tomography

IPA

Invasive pulmonary aspergillosis

IPF

Idiopathic pulmonary fibrosis

CCPA

Chronic cavitary pulmonary aspergillosis

CFPA

Chronic fibrosing pulmonary aspergillosis

CNPA

Chronic necrotising pulmonary aspergillosis

CPA

Chronic pulmonary aspergillosis

CT

Computed tomography

IPA

Invasive pulmonary aspergillosis

IPF

Idiopathic pulmonary fibrosis

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Fumito Okada.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was not required because this study was a retrospective study.

Informed consent

Written informed consent was not required for this study because this study was a retrospective study.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at three institutions

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Haruka Sato
    • 1
  • Fumito Okada
    • 2
  • Shunro Matsumoto
    • 2
  • Hiromu Mori
    • 2
  • Junji Kashiwagi
    • 1
  • Eiji Komatsu
    • 1
  • Toru Maeda
    • 1
  • Haruto Nishida
    • 3
  • Tsutomu Daa
    • 3
  • Satoshi Ohtani
    • 4
  • Kenji Umeki
    • 5
  • Masaru Ando
    • 5
  • Junichi Kadota
    • 5
  1. 1.Department of RadiologyOita Prefectural HospitalOitaJapan
  2. 2.Department of RadiologyOita University Faculty of MedicineYufuJapan
  3. 3.Department of Diagnostic PathologyOita University Faculty of MedicineOitaJapan
  4. 4.Department of Respiratory MedicineOita Prefectural HospitalOitaJapan
  5. 5.Department of Respiratory Medicine and Infectious DiseaseOita University Faculty of MedicineOitaJapan

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