HIGH-RESOLUTION COMPUTED TOMOGRAPHY IN THE EVALUATION OF FIBROSING ALVEOLITIS - 08/09/11
Resumen |
The first investigations of the utility of CT scanning in diffuse lung disease were undertaken in the mid-1980s, 6, 60, 104 and with further technical refinements, the full potential of high-resolution computed tomography (HRCT) has been realized. 50, 59 In the past 12 years, numerous HRCT/pathologic correlative studies have increased understanding of the fine detail provided by HRCT images, particularly in the perplexing conditions that are included in the term fibrosing alveolitis.
In the specific context of fibrosing lung disease, HRCT is increasingly used to detect early disease, when functional indices and plain chest radiography results are normal or equivocal. Comparative studies between the performance of HRCT and other noninvasive tests—particularly chest radiography—have repeatedly confirmed the superiority of HRCT for the diagnosis of fibrosing alveolitis, but caveats are necessary when considering such studies. By providing a precise assessment of disease pattern and extent, HRCT can provide information about the prognosis and reversibility in fibrosing lung disease. Further advantages of HRCT are the detection of complications and disorders associated with fibrosing alveolitis. In addition to the benefits that HRCT brings to the clinical management of patients with fibrosing alveolitis, new insights about the natural history and behavior of fibrosing alveolitis have been gained from recent HRCT studies.
For the purpose of this review, the term cryptogenic fibrosing alveolitis (synonymous with idiopathic pulmonary fibrosis) is used as the generic term that encompasses the various histopathologic subtypes (most frequently usual interstitial pneumonia). For clarity, occasional reference is made to the various subtypes that comprise the idiopathic interstitial pneumonias and readers wishing to acquaint themselves with the terminology that constitutes this confusing “alphabet soup” are referred to recent reviews. 37, 52, 56
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| Address reprint requests to: David M. Hansell, MD, FRCP, FRCR, Department of Radiology, Royal Brompton Hospital, Sydney Street, London SW 6NP, England, e-mail: d.hansell@rbh.nthames.nhs.uk |
Vol 20 - N° 4
P. 739-760 - décembre 1999 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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