Advertisement

Multislice CT pp 333-355 | Cite as

Interstitial Lung Diseases

  • Christina Mueller-Mang
  • Christina Plank
  • Helmut Ringl
  • Albert Dirisamer
  • Christian J. Herold
Chapter
  • 1.9k Downloads
Part of the Medical Radiology book series (MEDRAD)

Abstract

The term interstitial lung disease (ILD) comprises a diverse group of diseases that lead to inflammation and fibrosis of the alveoli, distal airways, and septal interstitium of the lungs. The ILDs consist of disorders of known cause (e.g., collagen vascular diseases, drug-related diseases) as well as disorders of unknown etiology. The latter include idiopathic interstitial pneumonias (IIPs), sarcoidosis and a group of miscellaneous, rare, but nonetheless interesting, diseases. In patients with ILD, MDCT enriches the diagnostic armamentarium by allowing volumetric high resolution scanning, i.e., continuous data acquisition with thin collimation and a high spatial frequency reconstruction algorithm. CT is a key method in the identification and management of patients with ILD. It not only improves the detection and characterization of parenchymal abnormalities, but also increases the accuracy of diagnosis. The spectrum of morphologic characteristics that are indicative of interstitial lung disease is relatively limited and includes a reticular pattern (with or without traction bronchiectasis), thickening of interlobular septa, honeycombing, nodules, and ground-glass opacities. In the correct clinical context, some patterns or combination of patterns, together with the anatomic distribution of the abnormality, i.e., from the lung apex to the base, or peripheral subpleural versus central bronchovascular, can lead the interpreter to a specific diagnosis. However, due to an overlap of the CT morphology between the various entities, complementary lung biopsy is recommended in virtually all cases of ILDs.

Keywords

Interstitial Lung Disease Usual Interstitial Pneumonia Pulmonary Alveolar Proteinosis Idiopathic Interstitial Pneumonia Traction Bronchiectasis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Abbott GF, Rosado-de-Christenson ML et al. (2004) From the archives of the AFIP: pulmonary Langerhans cell histiocytosis. Radiographics 24:821–841PubMedCrossRefGoogle Scholar
  2. Aberle DR, Hansell DM et al. (1990) Lymphangiomyomatosis: CT, chest radiographic, and functional correlations. Radiology 176:381–387PubMedGoogle Scholar
  3. Akira M, Kozuka T et al. (2005) Long-term follow-up CT scan evaluation in patients with pulmonary sarcoidosis. Chest 127:185–191PubMedCrossRefGoogle Scholar
  4. Akira M, Yamamoto S et al. (1997) Serial computed tomographic evaluation in desquamative interstitial pneumonia. Thorax 52:333–337PubMedGoogle Scholar
  5. Akira M, Yamamoto S et al. (1998) Bronchiolitis obliterans organizing pneumonia manifesting as multiple large nodules or masses. AJR Am J Roentgenol 170:291–295PubMedGoogle Scholar
  6. Albelda SM, Gefter WB et al. (1985) Diffuse pulmonary hemorrhage: a review and classification. Radiology 154:289–297PubMedGoogle Scholar
  7. Allen JN, Davis WB (1994) Eosinophilic lung diseases. Am J Respir Crit Care Med 150:1423–1438PubMedGoogle Scholar
  8. Anonymous (1999) Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 160:736–755Google Scholar
  9. Anonymous (2002) American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 165:277–304Google Scholar
  10. Ben-Dov I, Kishinevski Y et al. (1999) Pulmonary alveolar proteinosis in Israel: ethnic clustering. Isr Med Assoc J 1:75–78PubMedGoogle Scholar
  11. Bonelli FS, Hartman TE et al. (1998) Accuracy of high-resolution CT in diagnosing lung diseases. AJR Am J Roentgenol 170:1507–1512PubMedGoogle Scholar
  12. Bouros D, Hatzakis K et al. (2002) Association of malignancy with diseases causing interstitial pulmonary changes. Chest 121:1278–1289PubMedCrossRefGoogle Scholar
  13. Collins J, Hartman MJ et al. (2001) Frequency and CT findings of recurrent disease after lung transplantation. Radiology 219:503–509PubMedGoogle Scholar
  14. Cordier JF (2000) Organising pneumonia. Thorax 55:318–328PubMedCrossRefGoogle Scholar
  15. Costabel U, Hunninghake GW (1999) ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Statement Committee. American Thoracic Society. European Respiratory Society. World Association for Sarcoidosis and Other Granulomatous Disorders. Eur Respir J 14:735–737PubMedCrossRefGoogle Scholar
  16. Davis SD, Yankelevitz DF et al. (1992) Radiation effects on the lung: clinical features, pathology, and imaging findings. AJR Am J Roentgenol 159:1157–1164PubMedGoogle Scholar
  17. Desai SR, Nicholson AG et al. (1997) Benign pulmonary lymphocytic infiltration and amyloidosis: computed tomographic and pathologic features in three cases. J Thorac Imaging 12:215–220PubMedCrossRefGoogle Scholar
  18. Desai SR, Veeraraghavan S et al. (2004) CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology 232:560–567PubMedCrossRefGoogle Scholar
  19. Ellis SJ, Cleverley JR et al. (2000) Drug-induced lung disease: high-resolution CT findings. AJR Am J Roentgenol 175:1019–1024PubMedGoogle Scholar
  20. Franquet T, Hansell DM et al. (2003) Lung cysts in subacute hypersensitivity pneumonitis. J Comput Assist Tomogr 27:475–478PubMedCrossRefGoogle Scholar
  21. Grenier P, Valeyre D et al. (1991) Chronic diffuse interstitial lung disease: diagnostic value of chest radiography and high-resolution CT. Radiology 179:123–132PubMedGoogle Scholar
  22. Hansell DM (2001) High-resolution CT of diffuse lung disease: value and limitations. Radiol Clin North Am 39:1091–1113PubMedCrossRefGoogle Scholar
  23. Heyneman LE, Ward S et al. (1999) Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process? AJR Am J Roentgenol 173:1617–1622PubMedGoogle Scholar
  24. Holbert JM, Costello P et al. (2001) CT features of pulmonary alveolar proteinosis. AJR Am J Roentgenol 176:1287–1294PubMedGoogle Scholar
  25. Johkoh T, Muller NL et al. (2000) Eosinophilic lung diseases: diagnostic accuracy of thin-section CT in 111 patients. Radiology 216:773–780PubMedGoogle Scholar
  26. Johkoh T, Muller NL et al. (2002) Nonspecific interstitial pneumonia: correlation between thin-section CT findings and pathologic subgroups in 55 patients. Radiology 225:199–204PubMedCrossRefGoogle Scholar
  27. Johnson S (1999) Rare diseases. 1. Lymphangioleiomyomatosis: clinical features, management and basic mechanisms. Thorax 54:254–264PubMedCrossRefGoogle Scholar
  28. Katzenstein AL, Myers JL (1998) Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification. Am J Respir Crit Care Med 157:1301–1315PubMedGoogle Scholar
  29. Kim DS, Park JH et al. (2006) Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features. Eur Respir J 27:143–150PubMedCrossRefGoogle Scholar
  30. Kim EA, Lee KS et al. (2002) Interstitial lung diseases associated with collagen vascular diseases: radiologic and histopathologic findings. Radiographics 22:S151–S165PubMedCrossRefGoogle Scholar
  31. Kim KI, Kim CW et al. (2001) Imaging of occupational lung disease. Radiographics 21:1371–1391PubMedGoogle Scholar
  32. Korn MA, Schurawitzki H et al. (1992) Pulmonary alveolar microlithiasis: findings on high-resolution CT. AJR Am J Roentgenol 158:981–982PubMedGoogle Scholar
  33. Lee KS, Kullnig P et al. (1994) Cryptogenic organizing pneumonia: CT findings in 43 patients. AJR Am J Roentgenol 162:543–546PubMedGoogle Scholar
  34. Lenoir S, Grenier P et al. (1990) Pulmonary lymphangiomyomatosis and tuberous sclerosis: comparison of radiographic and thin-section CT findings. Radiology 175:329–334PubMedGoogle Scholar
  35. Marasco WJ, Fishman EK et al. (1993) Acute pulmonary hemorrhage. CT evaluation. Clin Imaging 17:77–80PubMedCrossRefGoogle Scholar
  36. Mayo JR, Webb WR et al. (1987) High-resolution CT of the lungs: an optimal approach. Radiology 163:507–510PubMedGoogle Scholar
  37. Mayo JR, Muller NL et al. (1989) Chronic eosinophilic pneumonia: CT findings in six cases. AJR Am J Roentgenol 153:727–730PubMedGoogle Scholar
  38. Mueller-Mang C, Grosse C et al. (2007) What every radiologist should know about idiopathic interstitial pneumonias. Radiographics 27:595–615PubMedCrossRefGoogle Scholar
  39. Murata K, Itoh H et al. (1986) Centrilobular lesions of the lung: demonstration by high-resolution CT and pathologic correlation. Radiology 161:641–645PubMedGoogle Scholar
  40. Murdoch J, Muller NL (1992) Pulmonary sarcoidosis: changes on follow-up CT examination. AJR Am J Roentgenol 159:473–477PubMedGoogle Scholar
  41. Nakatsu M, Hatabu H et al. (2002) Large coalescent parenchymal nodules in pulmonary sarcoidosis: sarcoid galaxy sign. AJR Am J Roentgenol 178:1389–1393PubMedGoogle Scholar
  42. Nishimura K, Itoh H et al. (1993) Pulmonary sarcoidosis: correlation of CT and histopathologic findings. Radiology 189:105–109PubMedGoogle Scholar
  43. Pallisa E, Sanz P et al. (2002) Lymphangioleiomyomatosis: pulmonary and abdominal findings with pathologic correlation. Radiographics 22:S185–S198PubMedGoogle Scholar
  44. Prakash UB, Barham SS et al. (1987) Pulmonary alveolar phospholipoproteinosis: experience with 34 cases and a review. Mayo Clin Proc 62:499–518PubMedGoogle Scholar
  45. Remy-Jardin M, Remy J et al. (1994) Lung changes in rheumatoid arthritis: CT findings. Radiology 193:375–382PubMedGoogle Scholar
  46. Rosen SH, Castleman B et al. (1958) Pulmonary alveolar proteinosis. N Engl J Med 258:1123–1142PubMedGoogle Scholar
  47. Rossi SE, Erasmus JJ et al. (2000) Pulmonary drug toxicity: radiologic and pathologic manifestations. Radiographics 20:1245–1259PubMedGoogle Scholar
  48. Silva CI, Muller NL et al. (2008) Chronic hypersensitivity pneumonitis: differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology 246:288–297PubMedGoogle Scholar
  49. Small JH, Flower CD et al. (1996) Air-trapping in extrinsic allergic alveolitis on computed tomography. Clin Radiol 51:684–688PubMedCrossRefGoogle Scholar
  50. Sosman MC, Dodd GD et al. (1957) The familial occurrence of pulmonary alveolar microlithiasis. Am J Roentgenol Radium Ther Nucl Med 77:947–1012PubMedGoogle Scholar
  51. Studler U, Gluecker T et al. (2005) Image quality from high-resolution CT of the lung: comparison of axial scans and of sections reconstructed from volumetric data acquired using MDCT. AJR Am J Roentgenol 185:602–607PubMedGoogle Scholar
  52. Swigris JJ, Berry GJ et al. (2002) Lymphoid interstitial pneumonia: a narrative review. Chest 122:2150–2164PubMedCrossRefGoogle Scholar
  53. Taylor JR, Ryu J et al. (1990) Lymphangioleiomyomatosis. Clinical course in 32 patients. N Engl J Med 323:1254–1260PubMedGoogle Scholar
  54. Tazelaar HD, Linz LJ et al. (1997) Acute eosinophilic pneumonia: histopathologic findings in nine patients. Am J Respir Crit Care Med 155:296–302PubMedGoogle Scholar
  55. Thabut G, Mal H et al. (2003) Survival benefit of lung transplantation for patients with idiopathic pulmonary fibrosis. J Thorac Cardiovasc Surg 126:469–475PubMedCrossRefGoogle Scholar
  56. Tomiyama N, Muller NL et al. (2000) Acute parenchymal lung disease in immunocompetent patients: diagnostic accuracy of high-resolution CT. AJR Am J Roentgenol 174:1745–1750PubMedGoogle Scholar
  57. Travis WD, Matsui K et al. (2000) Idiopathic nonspecific interstitial pneumonia: prognostic significance of cellular and fibrosing patterns: survival comparison with usual interstitial pneumonia and desquamative interstitial pneumonia. Am J Surg Pathol 24:19–33PubMedCrossRefGoogle Scholar
  58. Ucan ES, Keyf AI et al. (1993) Pulmonary alveolar microlithiasis: review of Turkish reports. Thorax 48:171–173PubMedCrossRefGoogle Scholar
  59. Webb WR (2006) Thin-section CT of the secondary pulmonary lobule: anatomy and the image—the 2004 Fleischner lecture. Radiology 239:322–338PubMedCrossRefGoogle Scholar
  60. Weibel ER (1979) Fleischner lecture. Looking into the lung: what can it tell us? AJR Am J Roentgenol 133:1021–1031PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Christina Mueller-Mang
    • 1
  • Christina Plank
    • 1
  • Helmut Ringl
    • 1
  • Albert Dirisamer
    • 1
  • Christian J. Herold
    • 1
  1. 1.Department of Diagnostic and Pediatric RadiologyMedical University of ViennaViennaAustria

Personalised recommendations