Seminars in ultrasound, CT, and MR
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Semin. Ultrasound CT MR · Feb 2014
ReviewHigh-resolution computed tomography findings of acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis.
Diffuse alveolar damage (DAD) is the pathologic feature of rapidly progressive lung diseases, including acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis. The clinical significance and limitation of high-resolution computed tomography (HRCT) findings in these diseases were reviewed. ⋯ Traction bronchiolectasis or bronchiectasis within areas of increased attenuation on HRCT scan is a sign of progression from the exudative to the proliferative and fibrotic phase of DAD. Extensive abnormalities seen on HRCT scans, which are indicative of fibroproliferative changes, were independently predictive of poor prognosis in patients with clinically early acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis.
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Semin. Ultrasound CT MR · Feb 2014
Comparative StudyConnective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonia: similarity and difference.
Interstitial lung diseases (ILDs) are increasingly recognized in patients with systemic diseases. Patients with early ILD changes may be asymptomatic. Features of ILD overlap among systemic diseases and with idiopathic variety. ⋯ Therapy- and complication-related lung changes would pose difficulty in diagnosing and classifying an ILD. Biology and prognosis of secondary ILDs may differ between different disease-related ILDs and idiopathic variety. Combination of clinical features, serological tests, pulmonary and extrapulmonary imaging findings, and pathology findings may help to diagnose ILDs.
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Semin. Ultrasound CT MR · Feb 2014
Histopathologic features of usual interstitial pneumonia and related patterns: what is important for radiologists?
In interstitial lung diseases, the diagnosis of idiopathic pulmonary fibrosis is important where pathology and radiology show usual interstitial pneumonia (UIP) pattern. Recently, revised guidelines of idiopathic pulmonary fibrosis were published in which the diagnostic algorithm requires a stricter definition for both pathology and radiology. ⋯ However, their distinction is important irrespective of the etiology, because the histologic UIP pattern indicates a significantly worse prognosis than other chronic interstitial lung diseases. In this review, we describe the histologic features of UIP, effects of revised guidelines, interobserver agreement, etiologic variations of UIP pattern, and finally we include a few of our hypothetical thoughts on the "UIP bucket."
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Semin. Ultrasound CT MR · Dec 2013
ReviewLymphoproliferative lung disorders: a radiologic-pathologic overview. Part I: Reactive disorders.
Lymphoid tissue is a normal component of the lung and manifests as intrapulmonary lymph nodes, bronchus-associated lymphoid tissue (BALT), peripheral lymphocytic aggregates, solitary lymphocytes, and phagocytic cells. Pulmonary lymphoid lesions are thought to develop as a consequence of anomalous stimulation and response of the bronchus-associated lymphoid tissue and manifests as a spectrum of lymphoproliferative disorders that may be reactive or neoplastic. ⋯ Affected patients are often asymptomatic. Imaging findings include focal nodules, diffuse bilateral centrilobular nodules, and hilar or mediastinal masses.
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Chest radiograph is the primary imaging modality for evaluation of chest pathology and computed tomography scan is typically performed when there is a need for better characterization of the pathology or for surgical planning. Ultrasound (US) is mainly used for the evaluation of pleural effusion. ⋯ US of the chest has various advantages including the use of nonionizing radiation, portability, and real-time guidance for interventional procedure. In this review, we discuss the use of US in evaluation of the chest wall, pleural space, lung parenchyma, mediastinum, and diaphragm in children.