Making a confident diagnosis is a complex task for a specific form of interstitial lung disease and providing appropriate management in an attempt to achieve normalization of the disease can put up an alarming process...Making a confident diagnosis is a complex task for a specific form of interstitial lung disease and providing appropriate management in an attempt to achieve normalization of the disease can put up an alarming process for the clinicians. A set of diffuse and restrictive lung diseases incorporate with idiopathic interstitial pneumonias, showing inflammation and fibrosis of the interstitium due to parenchymal damage. High-resolution computed tomography (HRCT) has magnified the diagnostic standpoint in stepwise identification and classified various patterns in the evaluation of interstitial lung disease. The aim of our review is to elaborate clinical, radiographic and typical and atypical HRCT findings of idiopathic interstitial pneumonias by correlating with its differential diagnosis. Idiopathic pulmonary fibrosis is the most predominant idiopathic interstitial pneumonias and its diagnosis needs to omit all other well-known causes of interstitial lung diseases. According to the 2011 evidence-based guidelines, usual interstitial pneumonia can be diagnosed by HRCT when all criteria are fulfilled. Non-specific interstitial pneumonia is distinguished by bilateral patchy ground-glass opacities and irregular linear/reticular opacities. Respiratory bronchiolitis associated-interstitial lung disease and desquamative interstitial pneumonia show centrolobular nodules and ground-glass opacities as imaging patterns. Cryptogenic organizing pneumonia consists of patchy peripheral or peribronchial consolidations, while ground-glass opacities with tendency for migration, which is evolving to fibrosis, in acute interstitial pneumonia. Lymphoid interstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis are classified under rare idiopathic interstitial pneumonias. HRCT images help radiologists in diagnosis and mapping specific patterns of idiopathic interstitial pneumonias. This article reviews the stages of evolution in HRCT features for idiopathic interstitial pneumonias.展开更多
Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists cou...Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. Methods: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. Results: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p Conclusion: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.展开更多
文摘Making a confident diagnosis is a complex task for a specific form of interstitial lung disease and providing appropriate management in an attempt to achieve normalization of the disease can put up an alarming process for the clinicians. A set of diffuse and restrictive lung diseases incorporate with idiopathic interstitial pneumonias, showing inflammation and fibrosis of the interstitium due to parenchymal damage. High-resolution computed tomography (HRCT) has magnified the diagnostic standpoint in stepwise identification and classified various patterns in the evaluation of interstitial lung disease. The aim of our review is to elaborate clinical, radiographic and typical and atypical HRCT findings of idiopathic interstitial pneumonias by correlating with its differential diagnosis. Idiopathic pulmonary fibrosis is the most predominant idiopathic interstitial pneumonias and its diagnosis needs to omit all other well-known causes of interstitial lung diseases. According to the 2011 evidence-based guidelines, usual interstitial pneumonia can be diagnosed by HRCT when all criteria are fulfilled. Non-specific interstitial pneumonia is distinguished by bilateral patchy ground-glass opacities and irregular linear/reticular opacities. Respiratory bronchiolitis associated-interstitial lung disease and desquamative interstitial pneumonia show centrolobular nodules and ground-glass opacities as imaging patterns. Cryptogenic organizing pneumonia consists of patchy peripheral or peribronchial consolidations, while ground-glass opacities with tendency for migration, which is evolving to fibrosis, in acute interstitial pneumonia. Lymphoid interstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis are classified under rare idiopathic interstitial pneumonias. HRCT images help radiologists in diagnosis and mapping specific patterns of idiopathic interstitial pneumonias. This article reviews the stages of evolution in HRCT features for idiopathic interstitial pneumonias.
文摘Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. Methods: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. Results: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p Conclusion: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.
