Alpha 1-antitrypsin deficiency CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mazia Fatima, MBBS [2]

Overview

On High-resolution CT (HRCT) scan of the chest: hypoattenuated areas resulting from a lack of lung tissue. As tissue is lost, pulmonary vessels appear smaller, fewer in number, and spread farther apart. Mild forms of alpha1-antitrypsin disease can be missed on HRCT scanning. However, when the disease is moderate, discerning the panlobular and characteristic lower zone predominance is possible. Severe forms may be indistinguishable from severe centrilobular emphysema. normal lung structures have been replaced by abnormal airspaces CT of abdomen may show hepatomegaly or changes associated with cirrhosis or hepatocellular carcinoma.

CT

On High-resolution CT (HRCT) scan of the chest:

• Hypoattenuated areas resulting from a lack of lung tissue. As tissue is lost, pulmonary vessels appear smaller, fewer in number, and spread farther apart. Mild forms of alpha1-antitrypsin disease can be missed on HRCT scanning.
• In cases of moderate severity, there is the panlobular and characteristic lower zone predominance.
• Severe disease is indistinguishable from severe centrilobular emphysema. Normal lung structures have been replaced by abnormal airspaces
• CT of abdomen can present as hepatomegaly and associated with cirrhosis or hepatocellular carcinoma.

Emphysematous changes with lower lobe predominance.Case courtesy of Dr Yune Kwong, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/30763">rID: 30763</a>

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