[Allergic bronchopulmonary aspergillosis-essential knowledge for radiology].

clinical/methodical issueAllergic bronchopulmonary aspergillosis (ABPA) is a rare but potentially severe hypersensitivity reaction to Aspergillus fumigatus, primarily affecting patients with asthma or cystic fibrosis. Early diagnosis is crucial to prevent irreversible lung damage. STANDARD RADIOLOGICAL

methodsHigh-resolution computed tomography (HRCT) is the standard imaging method for detecting bronchiectasis and other typical findings. Common features include central, saccular bronchiectasis, mucus impaction, and centrilobular micronodules. Radiological assessment must be closely integrated with clinical and laboratory parameters. METHODICAL INNOVATIONS: The revised 2024 International Society for Human and Animal Mycology (ISHAM) criteria further emphasize the diagnostic importance of radiological features. High-attenuation mucus (HAM) is considered a highly specific finding and may confirm the diagnosis. Modern classification systems allow more precise disease staging. PERFORMANCE: HRCT provides extremely high sensitivity for the radiological hallmarks of ABPA. Detection of HAM is regarded as nearly pathognomonic. Fleeting infiltrates and reversible changes are reliably visualized. Correlating radiological findings with laboratory parameters significantly improves diagnostic accuracy. ACHIEVEMENTS: HRCT remains the indispensable imaging modality for diagnosing and monitoring ABPA. PRACTICAL RECOMMENDATIONS: In cases of clinical suspicion, early HRCT of the thorax should be performed. A combination of radiological findings and serological criteria is recommended to confirm the diagnosis. HRCT can be used to detect reversible infiltrates and assess response to treatment.