Small airways disease
Citation, DOI, disclosures and article data
Citation:
Weerakkody Y, Knipe H, Di Muzio B, Small airways disease. Reference article, Radiopaedia.org (Accessed on 13 Mar 2025) https://doi.org/10.53347/rID-22818
rID:
22818
Article created:
Disclosures:
At the time the article was created Yuranga Weerakkody had no recorded disclosures.
View Yuranga Weerakkody's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Revisions:
7 times, by
3 contributors -
see full revision history and disclosures
Systems:
Synonyms:
- Small air ways inflammatory disease
- Small airways inflammatory diseases
- Small airways diseases
- Peripheral airways disease
- Peripheral airways diseases
- Small airways disease (SAD)
- Small airway disease
Small airways disease comprise a group of infectious as well as non-infectious conditions that affect the small airways (i.e. airways that are more peripheral to the main bronchi and proximal bronchioles (4th the 14th generation) - arbitrarily considered to be those with an internal diameter of ≤2 mm 3).
Pathology
While some authors consider this term synonymous with bronchiolitis 4, conditions such as asthma may also fall under this group 7. There are also many other conditions that can affect or be associated with small airways, which include:
drug-induced small airways disease
COVID-19 infection - usually as a delayed / late sequelae 12,13
-
connective tissues diseases
pulmonary manifestations of inflammatory bowel disease 11
Sjogren syndrome 9-10
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Radiographic features
CT
There are many CT features associated with small airways disease, which include:
-
direct signs
thickened peripheral airways: may only be seen in the proximal portion
-
indirect signs (many of these features may be nonspecific on their own):
tree-in-bud changes 1,8
References
- 1. Sharma V, Shaaban AM, Berges G et-al. The radiological spectrum of small-airway diseases. Semin. Ultrasound CT MR. 2003;23 (4): 339-51. Pubmed citation
- 2. Tasker AD, Flower CD. Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease. Clin. Chest Med. 2000;20 (4): 761-73, viii. Pubmed citation
- 3. Hansell DM. Small airways diseases: detection and insights with computed tomography. Eur. Respir. J. 2001;17 (6): 1294-313. Pubmed citation
- 4. Franquet T, Müller NL. Disorders of the small airways: high-resolution computed tomographic features. Semin Respir Crit Care Med. 2003;24 (04): 437-44. doi:10.1055/s-2003-42378 - Pubmed citation
- 5. Abbott GF, Rosado-De-Christenson ML, Rossi SE et-al. Imaging of small airways disease. J Thorac Imaging. 2009;24 (4): 285-98. doi:10.1097/RTI.0b013e3181c1ab83 - Pubmed citation
- 6. Waitches GM, Stern EJ. High-resolution CT of peripheral airways diseases. Radiol. Clin. North Am. 2002;40 (1): 21-9. Pubmed citation
- 7. Teel GS, Engeler CE, Tashijian JH et-al. Imaging of small airways disease. Radiographics. 1996;16 (1): 27-41. Radiographics (abstract) - Pubmed citation
- 8. Rossi SE, Franquet T, Volpacchio M et-al. Tree-in-bud pattern at thin-section CT of the lungs: radiologic-pathologic overview. Radiographics. 2005;25 (3): 789-801. Radiographics (full text) - doi:10.1148/rg.253045115 - Pubmed citation
- 9. Papiris SA, Maniati M, Constantopoulos SH et-al. Lung involvement in primary Sjögren's syndrome is mainly related to the small airway disease. Ann. Rheum. Dis. 1999;58 (1): 61-4. Free text at pubmed - Pubmed citation
- 10. Nakanishi M, Fukuoka J, Tanaka T et-al. Small airway disease associated with Sjögren's syndrome: clinico-pathological correlations. Respir Med. 2011;105 (12): 1931-8. doi:10.1016/j.rmed.2011.08.009 - Pubmed citation
- 11. Pierre-Régis Burgel, Anne Bergeron, Jacques de Blic, Philippe Bonniaud, Arnaud Bourdin, Pascal Chanez, Thierry Chinet, Jean-Charles Dalphin, Philippe Devillier, Antoine Deschildre, Alain Didier, Marianne Kambouchner, Christiane Knoop, François Laurent, Hilario Nunes, Thierry Perez, Nicolas Roche, Isabelle Tillie-Leblond, Daniel Dusser. Small airways diseases, excluding asthma and COPD: an overview. European Respiratory Review. 22 (128): 131. doi:10.1183/09059180.00001313 - Pubmed
- 12. Huang R, Zhu J, Zhou J et al. Inspiratory and Expiratory Chest High-Resolution CT: Small-Airway Disease Evaluation in Patients with COVID-19. Curr Med Imaging. 2021;17(11):1299-307. doi:10.2174/1573405617999210112194621 - Pubmed
- 13. Cho J, Villacreses R, Nagpal P et al. Quantitative Chest CT Assessment of Small Airways Disease in Post-Acute SARS-CoV-2 Infection. Radiology. 2022;304(1):185-92. doi:10.1148/radiol.212170 - Pubmed
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