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High-resolution computed tomography in the diagnosis and follow-up of idiopathic pulmonary fibrosis

La tomografia computerizzata ad alta risoluzione nella diagnosi e nella valutazione evolutiva della fibrosi polmonare idiopatica

  • Chest Radiology / Radiologia Toracica
  • Published:
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Abstract

Idiopathic pulmonary fibrosis (IPF) is the most common interstitial lung disease and is associated with a fatal prognosis. Familiarity with the typical appearances of IPF on high-resolution computed tomography (HRCT) is important, as in the appropriate clinical setting, it is often sufficient for establishing a confident diagnosis of IPF without the need for surgical biopsy. Moreover, HRCT can provide important prognostic information in IPF. This is noteworthy, as the course of IPF is variable, and many patients develop complications leading to respiratory failure and death. The purpose of this paper is to review the progress made towards a better understanding of the HRCT patterns of IPF.

Riassunto

La fibrosi polmonare idiopatica (idiopathic pulmonary fibrosis, IPF) è la più comune interstiziopatia ed è associata ad una prognosi infausta. È importante avere famigliarità con le tipiche alterazioni della IPF alla tomografia computerizzata ad alta risoluzione (highresolution computer tomography, HRCT), poiché queste, in combinazione con un profilo clinico compatibile, sono spesso sufficienti per ottenere la diagnosi di IPF senza il bisogno di ricorrere alla biopsia chirurgica. Inoltre, la HRCT può fornire importanti informazioni prognostiche per i pazienti con IPF. Questo è importante in considerazione del comportamento variabile della malattia, con molti pazienti in cui si osserva l’insorgenza di complicanze che conducono all’insufficienza respiratoria e alla morte. L’obiettivo di questo articolo è quello di riassumere i recenti progressi fatti verso una migliore comprensione degli aspetti sopra-riportati della IPF.

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References/Bibliografia

  1. American Thoracic Society (2000) Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med 161:646–664

    Google Scholar 

  2. Maher TM, Wells AU, Laurent GJ (2007) Idiopathic pulmonary fibrosis: multiple causes and multiple mechanisms? Eur Respir J 30:835–839

    Article  CAS  PubMed  Google Scholar 

  3. American Thoracic Society; European Respiratory Society (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 165:277–304

    Google Scholar 

  4. Raghu G, Weycker D, Edelsberg J et al (2006) Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 174:810–816

    Article  PubMed  Google Scholar 

  5. du Bois RM, Wells AU (2001) Cryptogenic fibrosing alveolitis/idiopathic pulmonary fibrosis. Eur Respir J Suppl 32:43s–55s

    PubMed  Google Scholar 

  6. Steele MP, Speer MC, Loyd JE et al (2005) Clinical and pathologic features of familial interstitial pneumonia. Am J Respir Crit Care Med 172:1146–1152

    Article  PubMed  Google Scholar 

  7. Visscher DW, Myers JL (2006) Histologic spectrum of idiopathic interstitial pneumonias. Proc Am Thorac Soc 3:322–329

    Article  PubMed  Google Scholar 

  8. King TE Jr, Schwarz MI, Brown K et al (2001) Idiopathic pulmonary fibrosis: relationship between histopathologic features and mortality. Am J Respir Crit Care Med 164:1025–1032

    PubMed  Google Scholar 

  9. Olson AL, Swigris JJ, Lezotte DC et al (2007) Mortality from pulmonary fibrosis increased in the United States from 1992 to 2003. Am J Respir Crit Care Med 176:277–284

    Article  PubMed  Google Scholar 

  10. Churg A, Müller NL, Silva CI et al (2007) Acute exacerbation (acute lung injury of unknown cause) in UIP and other forms of fibrotic interstitial pneumonias. Am J Surg Pathol 31:277–284

    Article  PubMed  Google Scholar 

  11. Kim DS, Collard HR, King TE Jr (2006) Classification and natural history of the idiopathic interstitial pneumonias. Proc Am Thorac Soc 3:285–292

    Article  PubMed  Google Scholar 

  12. Kondoh Y, Taniguchi H, Kitaichi M et al (2006) Acute exacerbation of interstitial pneumonia following surgical lung biopsy. Respir Med 100:1753–1759

    Article  PubMed  Google Scholar 

  13. Martinez FJ, Safrin S, Weycker D (2005) The clinical course of patients with idiopathic pulmonary fibrosis. Ann Intern Med 142:963–967

    PubMed  Google Scholar 

  14. Lynch DA, Travis WD, Müller NL et al (2005) Idiopathic interstitial pneumonias: CT features. Radiology 236:10–21

    Article  PubMed  Google Scholar 

  15. Mueller-Mang C, Grosse C, Schmid K et al (2007) What every radiologist should know about idiopathic interstitial pneumonias. Radiographics 27:595–615

    Article  PubMed  Google Scholar 

  16. Battista G, Sassi C, Zompatori M et al (2003) Ground-glass opacity: interpretation of high resolution CT findings. Radiol Med 106:425–442

    PubMed  Google Scholar 

  17. Spaggiari E, Zompatori M, Verduri A et al (2005) Early smoking-induced lung lesions in asymptomatic subjects. Correlations between high resolution dynamic CT and pulmonary function testing. Radiol Med 109:27–39

    CAS  PubMed  Google Scholar 

  18. Mejía M, Carrillo G, Rojas-Serrano J et al (2009) Idiopathic pulmonary fibrosis and emphysema: decreased survival associated with severe pulmonary arterial hypertension. Chest 136:10–15

    Article  PubMed  Google Scholar 

  19. Cottin V, Nunes H, Brillet PY et al (2005) Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. Eur Respir J 26:586–593

    Article  CAS  PubMed  Google Scholar 

  20. Kligerman SJ, Groshong S, Brown KK et al (2009) Nonspecific interstitial pneumonia: radiologic, clinical, and pathologic considerations. Radiographics 29:73–87

    Article  PubMed  Google Scholar 

  21. Sumikawa H, Johkoh T, Ichikado K et al (2006) Usual interstitial pneumonia and chronic idiopathic interstitial pneumonia: analysis of CT appearance in 92 patients. Radiology 241:258–266

    Article  PubMed  Google Scholar 

  22. Zompatori M, Calabrò E, Chetta A et al (2003) Chronic hypersensitivity pneumonitis or idiopathic pulmonary fibrosis? Diagnostic role of high resolution computed tomography (HRCT). Radiol Med 106:135–146

    PubMed  Google Scholar 

  23. Park JH, Kim DS, Park IN et al (2007) Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease-related subtypes. Am J Respir Crit Care Med 175:705–711

    Article  PubMed  Google Scholar 

  24. Flaherty KR, Thwaite EL, Kazerooni EA et al (2003) Radiological versus histological diagnosis in UIP and NSIP: survival implications. Thorax 58:143–148

    Article  CAS  PubMed  Google Scholar 

  25. Sumikawa H, Johkoh T, Colby TV et al (2008) Computed tomography findings in pathological usual interstitial pneumonia: relationship to survival. Am J Respir Crit Care Med 177:433–439

    Article  PubMed  Google Scholar 

  26. Best AC, Meng J, Lynch AM et al (2008) Idiopathic pulmonary fibrosis: physiologic tests, quantitative CT indexes, and CT visual scores as predictors of mortality. Radiology 246:935–940

    Article  PubMed  Google Scholar 

  27. Shin KM, Lee KS, Chung MP et al (2008) Prognostic determinants among clinical, thin-section CT, and histopathologic findings for fibrotic idiopathic interstitial pneumonias: tertiary hospital study. Radiology 249:328–337

    Article  PubMed  Google Scholar 

  28. Staples CA, Müller NL, Vedal S et al (1987) Usual interstitial pneumonia: correlation of CT with clinical, functional, and radiologic findings. Radiology 162:377–381

    CAS  PubMed  Google Scholar 

  29. Wells AU, King AD, Rubens MB et al (1997) Lone cryptogenic fibrosing alveolitis: a functional-morphologic correlation based on extent of disease on thin-section computed tomography. Am J Respir Crit Care Med 155:1367–1375

    CAS  PubMed  Google Scholar 

  30. Wells AU, Desai SR, Rubens MB et al (2003) Idiopathic pulmonary fibrosis: a composite physiologic index derived from disease extent observed by computed tomography. Am J Respir Crit Care Med 167:962–969

    Article  PubMed  Google Scholar 

  31. Strickland NH, Hughes JM, Hart DA et al (1993) Cause of regional ventilation-perfusion mismatching in patients with idiopathic pulmonary fibrosis: a combined CT and scintigraphic study. AJR Am J Roentgenol 161:719–725

    CAS  PubMed  Google Scholar 

  32. Mino M, Noma S, Kobashi Y et al (1995) Serial changes of cystic air spaces in fibrosing alveolitis: a CT-pathological study. Clin Radiol 50:357–363

    Article  CAS  PubMed  Google Scholar 

  33. Silva CI, Müller NL, Fujimoto K et al (2007) Acute exacerbation of chronic interstitial pneumonia: high-resolution computed tomography and pathologic findings. J Thorac Imaging 22:221–229

    Article  PubMed  Google Scholar 

  34. Kim DS, Park JH, Park BK et al (2006) Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features. Eur Respir J 27:143–150

    Article  CAS  PubMed  Google Scholar 

  35. Park J, Kim DS, Shim TS et al (2001) Lung cancer in patients with idiopathic pulmonary fibrosis. Eur Respir J 17:1216–1219

    Article  CAS  PubMed  Google Scholar 

  36. Franquet T, Gimenez A, Alegret X et al (1998) Mediastinal lymphadenopathy in cryptogenic fibrosing alveolitis: the effect of steroid therapy on the prevalence of nodal enlargement. Clin Radiol 53:435–438

    Article  CAS  PubMed  Google Scholar 

  37. Lee HJ, Im JG, Ahn JM et al (1996) Lung cancer in patients with idiopathic pulmonary fibrosis: CT findings. J Comput Assist Tomogr 20:979–982

    Article  CAS  PubMed  Google Scholar 

  38. Devaraj A, Wells AU, Meister MG et al (2008) The effect of diffuse pulmonary fibrosis on the reliability of CT signs of pulmonary hypertension. Radiology 249:1042–1049

    Article  PubMed  Google Scholar 

  39. Lettieri CJ, Nathan SD, Barnett SD et al (2006) Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest 129:746–752

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di Scienze Cliniche, Sezione di Diagnostica per Immagini, Università degli Studi di Parma, Parma, Italy

    N. Sverzellati & M. De Filippo

  2. Dottorato di Scienze Pneumo-Cardio-Toraciche di Interesse Medico e Chirurgico, Università di Bologna, Bologna, Italy

    T. Bartalena

  3. U.O. Radiologia IRST, Istituto Scientifico Romagnolo per lo Studio e la cura dei Tumori, Meldola-Forlì, Italy

    S. Piciucchi

  4. Radiologia III — Pol. S.Orsola-Malpighi, Bologna, Italy

    M. Zompatori

  5. Padiglione Barbieri, Sezione di Diagnostica per Immagini, Azienda Ospedaliero-Universitaria di Parma, 43100, Parma, Italy

    N. Sverzellati

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  1. N. Sverzellati
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  2. M. De Filippo
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  3. T. Bartalena
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  4. S. Piciucchi
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  5. M. Zompatori
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Correspondence to N. Sverzellati.

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Sverzellati, N., De Filippo, M., Bartalena, T. et al. High-resolution computed tomography in the diagnosis and follow-up of idiopathic pulmonary fibrosis. Radiol med 115, 526–538 (2010). https://doi.org/10.1007/s11547-010-0512-5

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  • DOI: https://doi.org/10.1007/s11547-010-0512-5

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