{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:53:47Z","timestamp":1792068827649,"version":"4.4.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>High\u2010attenuation mucus (HAM) is a specific manifestation of allergic bronchopulmonary mycosis (ABPM) on chest computed tomography (CT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare the diagnostic accuracy of the two definitions of HAM and to clarify the clinical and radiographic characteristics of HAM\u2010positive and HAM\u2010negative ABPM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>CT images at the diagnosis of ABPM using Asano's criteria were retrospectively analysed. In Study #1, radiographic data obtained using the same CT apparatus in a single institute were analysed to determine the agreement between the two definitions of HAM: a mucus plug that is visually denser than the paraspinal muscles or that with a radiodensity \u226570 Hounsfield units. In Study #2, HAM was diagnosed by comparison with the paraspinal muscles in patients with ABPM reporting to 14 medical institutes in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In Study #1, 93 mucus plugs from 26 patients were analysed. A substantial agreement for HAM diagnosis was observed between the two methods, with a \u03ba coefficient of 0.72. In Study #2, 60 cases of ABPM were analysed; mucus plugs were present in all cases and HAM was diagnosed in 45 (75%) cases. The median <jats:italic>A.\u2009fumigatus<\/jats:italic>\u2010specific IgE titre was significantly lower in HAM\u2010positive patients than in HAM\u2010negative patients (2.5 vs. 24.3 U<jats:sub>A<\/jats:sub>\/mL, <jats:italic>p<\/jats:italic>\u2009=\u2009.004). Nodular shadows were observed more frequently in the airways distal to HAM than in those distal to non\u2010HAM mucus plugs (59% vs. 32%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, agreement between the two methods to diagnose HAM was substantial. HAM was associated with some immunological and radiographic characteristics, including lower levels of sensitization to <jats:italic>A.\u2009fumigatus<\/jats:italic> and the presence of distal airway lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13705","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T03:34:14Z","timestamp":1708313654000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["High attenuation mucus in bronchi with allergic bronchopulmonary mycosis"],"prefix":"10.1111","volume":"67","author":[{"given":"Shigeaki","family":"Hattori","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine Tokai University School of Medicine  Kanagawa 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