High-resolution computed tomographic imaging of airways in sarcoidosis patients with airflow obstruction.

Objective: To investigate airway involvement in patients with pulmonary sarcoidosis and airflow obstruction (AO) using high-resolution computed tomography. Methods: Forty-two sarcoidosis patients with AO and 42 matched sarcoidosis patients without AO were retrospectively analyzed. High-resolution computed tomographic patterns of airway involvement were bronchial distortion, peribronchovascular thickening, small airway obstruction, and bronchial compression by enlarged lymph nodes. Results: Interobserver agreement was good (κ > 0.8). High-resolution computed tomographic patterns of airway involvement were found more frequently, scored higher, and were more often multiple (P < 0.05) in patients with AO than those without. Functional improvement under treatment was observed more frequently in patients with predominant peribronchovascular thickening compared with patients with predominant bronchial distortion (P < 0.03). Conclusions: In pulmonary sarcoidosis patients with AO, high-resolution computed tomography is a reliable tool to identify underlying airways involvements, which are often multiple, and enables prediction of the therapeutic response.