Which diagnostic study most clearly demonstrates bronchiectasis by showing dilated and thickened bronchi?

• A. Chest X-ray
• B. Pulmonary angiography
• C. Echocardiography
• D. CT scan showing dilated bronchi with wall thickening

Answer: (D)

Bronchiectasis is best confirmed when you can actually see the airways dilated and the walls thickened. A CT scan, especially high‑resolution CT, provides the detailed cross‑sectional images of the lungs that clearly show these structural airway changes. On a CT you’ll see bronchi that are abnormally wide with thickened walls and a lack of normal tapering as they extend toward the periphery, sometimes described by signs like the signet ring or tram‑track appearance. This direct visualization makes CT the most definitive test for bronchiectasis.

Chest X‑ray can miss or underestimate bronchiectasis because it’s not sensitive enough to reveal subtle airway dilation or wall thickening. Imaging focused on vessels or the heart, such as pulmonary angiography or echocardiography, doesn’t visualize the airways in the same way and won’t demonstrate bronchiectasis.