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Highlights of HRCT imaging in IPF.

Sverzellati N - Respir. Res. (2013)

Bottom Line: Advances in HRCT scanning and interpretation have facilitated improved accuracy for use in diagnosing IPF, eliminating the need for a surgical biopsy in many patients.The role of routine follow-up with HRCT to monitor patients with IPF remains unclear due to lack of sufficient evidence, although, sometimes follow-up HRCT might be necessary to rule out progressive disease in patients with undetermined diagnosis.Advances in the field of HRCT imaging are discussed, along with insights into the clinical utility of this procedure in the diagnosis and management of IPF.

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Affiliation: Scienze Radiologiche, Padiglione Barbieri, Azienda Ospealiero-Universitaria di Parma, V, Gramsci 14, 43100 Parma, Italy.

ABSTRACT
High-resolution computed tomography (HRCT) imaging has a central role in the diagnosis of interstitial lung diseases, particularly in the evaluation of patients with suspected idiopathic pulmonary fibrosis (IPF). In approximately half of cases, HRCT scans are sufficient to allow a confident IPF diagnosis. Advances in HRCT scanning and interpretation have facilitated improved accuracy for use in diagnosing IPF, eliminating the need for a surgical biopsy in many patients. HRCT may also have a role to play in predicting the prognosis of the disease;. The role of routine follow-up with HRCT to monitor patients with IPF remains unclear due to lack of sufficient evidence, although, sometimes follow-up HRCT might be necessary to rule out progressive disease in patients with undetermined diagnosis. Advances in the field of HRCT imaging are discussed, along with insights into the clinical utility of this procedure in the diagnosis and management of IPF.

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Biopsy-proved UIP with an HRCT pattern inconsistent with UIP. There are some patchy ground-glass and peripheral reticular opacities. which are more suggestive of nonspecific interstitial pneumonia (NSIP).
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Figure 3: Biopsy-proved UIP with an HRCT pattern inconsistent with UIP. There are some patchy ground-glass and peripheral reticular opacities. which are more suggestive of nonspecific interstitial pneumonia (NSIP).

Mentions: It is very important to realize that approximately half of cases with biopsy-proven UIP does not show a definite HRCT pattern owing to either the absence of typical findings (i.e. honeycombing) (Fig. 2), or the presence of findings (e.g. predominant ground-glass opacity, consolidation, nodules etc.) suggesting alternative diagnoses (Fig. 3) [3,30,31]. Such atypical HRCT patterns of UIP are very similar or identical to those of NSIP, although in clinical practice, they are likely to be misdiagnosed as a wider range of diseases (e.g. chronic hypersensitivity pneumonitis and sarcoidosis) [31].


Highlights of HRCT imaging in IPF.

Sverzellati N - Respir. Res. (2013)

Biopsy-proved UIP with an HRCT pattern inconsistent with UIP. There are some patchy ground-glass and peripheral reticular opacities. which are more suggestive of nonspecific interstitial pneumonia (NSIP).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643237&req=5

Figure 3: Biopsy-proved UIP with an HRCT pattern inconsistent with UIP. There are some patchy ground-glass and peripheral reticular opacities. which are more suggestive of nonspecific interstitial pneumonia (NSIP).
Mentions: It is very important to realize that approximately half of cases with biopsy-proven UIP does not show a definite HRCT pattern owing to either the absence of typical findings (i.e. honeycombing) (Fig. 2), or the presence of findings (e.g. predominant ground-glass opacity, consolidation, nodules etc.) suggesting alternative diagnoses (Fig. 3) [3,30,31]. Such atypical HRCT patterns of UIP are very similar or identical to those of NSIP, although in clinical practice, they are likely to be misdiagnosed as a wider range of diseases (e.g. chronic hypersensitivity pneumonitis and sarcoidosis) [31].

Bottom Line: Advances in HRCT scanning and interpretation have facilitated improved accuracy for use in diagnosing IPF, eliminating the need for a surgical biopsy in many patients.The role of routine follow-up with HRCT to monitor patients with IPF remains unclear due to lack of sufficient evidence, although, sometimes follow-up HRCT might be necessary to rule out progressive disease in patients with undetermined diagnosis.Advances in the field of HRCT imaging are discussed, along with insights into the clinical utility of this procedure in the diagnosis and management of IPF.

View Article: PubMed Central - HTML - PubMed

Affiliation: Scienze Radiologiche, Padiglione Barbieri, Azienda Ospealiero-Universitaria di Parma, V, Gramsci 14, 43100 Parma, Italy.

ABSTRACT
High-resolution computed tomography (HRCT) imaging has a central role in the diagnosis of interstitial lung diseases, particularly in the evaluation of patients with suspected idiopathic pulmonary fibrosis (IPF). In approximately half of cases, HRCT scans are sufficient to allow a confident IPF diagnosis. Advances in HRCT scanning and interpretation have facilitated improved accuracy for use in diagnosing IPF, eliminating the need for a surgical biopsy in many patients. HRCT may also have a role to play in predicting the prognosis of the disease;. The role of routine follow-up with HRCT to monitor patients with IPF remains unclear due to lack of sufficient evidence, although, sometimes follow-up HRCT might be necessary to rule out progressive disease in patients with undetermined diagnosis. Advances in the field of HRCT imaging are discussed, along with insights into the clinical utility of this procedure in the diagnosis and management of IPF.

Show MeSH
Related in: MedlinePlus