scholarly journals The New Useful High-Resolution Computed Tomography Finding for Diagnosing Fibrotic Hypersensitivity Pneumonitis: “Hexagonal Pattern”: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
Hiroko Okabayashi ◽  
Taiki Fukuda ◽  
Tae Iwasawa ◽  
Tsuneyuki Oda ◽  
Hideya Kitamura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Hypersensitivity Pneumonitis ◽  
Ground Glass Opacity ◽  
High Resolution Computed Tomography ◽  
Air Trapping ◽  
Hexagonal Pattern ◽  
Significant Difference ◽  
Tomography Finding ◽  
Density Pattern

Abstract Background Centrilobular nodules, ground-glass opacity (GGO), mosaic attenuation, air trapping, and three-density pattern were reported as high-resolution computed tomography (HRCT) findings characteristic of fibrotic hypersensitivity pneumonitis (HP). However, it is often difficult to differentiate fibrotic HP from idiopathic pulmonary fibrosis (IPF). In fibrotic HP, the HRCT sometimes shows tortoiseshell-like interlobular septal thickening that extends from the subpleural lesion to the inner layers. This finding is called “hexagonal pattern,” and this study is focused on the possibility that such finding is useful for differentiating fibrotic HP from IPF. Methods This study included patients with multidisciplinary discussion (MDD) diagnosis of fibrotic HP or IPF undergoing surgical lung biopsy between January 2015 and December 2017 in Kanagawa Cardiovascular and Respiratory Center. Two radiologists have evaluated the HRCT findings without clinical and pathological information. Results A total of 23 patients were diagnosed with fibrotic HP by MDD and 48 with IPF. Extensive GGO, centrilobular nodules, and hexagonal pattern were more frequent findings in fibrotic HP than in IPF. No significant difference was observed between the two groups in the presence or absence of mosaic attenuation, air trapping, or three-density pattern. In the multivariate logistic regression, the presence of extensive GGO and hexagonal pattern was associated with increased odds ratio of fibrotic HP. The sensitivity and specificity of the diagnosis of fibrotic HP in the presence of the hexagonal pattern were 69.6% and 87.5%, respectively. Conclusion Hexagonal pattern is a useful finding for differentiating fibrotic HP from IPF.

scholarly journals Hypersensitivity Pneumonitis High-resolution Computed Tomography Findings, and Their Correlation with the Etiology and the Disease Duration

2020 ◽  
Vol 121 (3) ◽  
pp. 133-141
Author(s):  
Farzaneh Shobeirian ◽  
Payam Mehrian ◽  
Abtin Doroudinia
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Hypersensitivity Pneumonitis ◽  
Care Center ◽  
Tertiary Care ◽  
Ground Glass Opacity ◽  
Final Diagnosis ◽  
Ground Glass ◽  
High Resolution Computed Tomography ◽  
Diffuse Parenchymal Lung Disease

Hypersensitivity pneumonitis (HP) is an immune-mediated diffuse parenchymal lung disease induced by inhaled antigens. High-resolution computed tomography (HRCT) is widely used in the diagnosis and follow-up of patients and determining the progression and prognosis of the disease. In this retrospective study, 45 consecutive patients with the final diagnosis of HP, seen at a large tertiary care center during a period of 4 years, were included and their HRCT findings were evaluated. The most common HRCT findings were ground glass opacity and reticulation. Some HRCT patterns were detected more severely in bird fanciers in comparison with other etiologies. There is no “gold standard” for the diagnosis of HP. HRCT findings play an important role in hypersensitivity pneumonitis diagnosis and CT scan also help to define the severity of hypersensitivity pneumonitis injuries. In our study, reticulation and ground glass opacity were the most common findings in HRCT of patients with HP. We also find that patients with avian contacts had a significantly higher rate of fibrosis.

scholarly journals The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 439
Author(s):  
Donato Lacedonia ◽  
Giulia Scioscia ◽  
Angelamaria Giardinelli ◽  
Carla Maria Irene Quarato ◽  
Ennio Vincenzo Sassani ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
High Resolution Computed Tomography ◽  
Pleural Line ◽  
Complementary Role ◽  
Number Of Patients ◽  
Significant Difference ◽  
Transthoracic Ultrasound

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

scholarly journals High-resolution computed tomography and histopathological findings in hypersensitivity pneumonitis: a pictorial essay

2016 ◽  
Vol 49 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Pedro Paulo Teixeira e Silva Torres ◽  
Marise Amaral Rebouças Moreira ◽  
Daniela Graner Schuwartz Tannus Silva ◽  
Roberta Rodrigues Monteiro da Gama ◽  
Denis Masashi Sugita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Biopsy ◽  
Hypersensitivity Pneumonitis ◽  
Giant Cells ◽  
Clinical Findings ◽  
High Resolution Computed Tomography ◽  
Histopathological Findings ◽  
Pictorial Essay ◽  
Inflammatory Infiltrates

Abstract Hypersensitivity pneumonitis is a diffuse interstitial and granulomatous lung disease caused by the inhalation of any one of a number of antigens. The objective of this study was to illustrate the spectrum of abnormalities in high-resolution computed tomography and histopathological findings related to hypersensitivity pneumonitis. We retrospectively evaluated patients who had been diagnosed with hypersensitivity pneumonitis (on the basis of clinical-radiological or clinical-radiological-pathological correlations) and had undergone lung biopsy. Hypersensitivity pneumonitis is clinically divided into acute, subacute, and chronic forms; high-resolution computed tomography findings correlate with the time of exposure; and the two occasionally overlap. In the subacute form, centrilobular micronodules, ground-glass opacities, and air trapping are characteristic high-resolution computed tomography findings, whereas histopathology shows lymphocytic inflammatory infiltrates, bronchiolitis, variable degrees of organizing pneumonia, and giant cells. In the chronic form, high-resolution computed tomography shows traction bronchiectasis, honeycombing, and lung fibrosis, the last also being seen in the biopsy sample. A definitive diagnosis of hypersensitivity pneumonitis can be made only through a multidisciplinary approach, by correlating clinical findings, exposure history, high-resolution computed tomography findings, and lung biopsy findings.

Investigation of optimal viewing size for detecting nodular ground-glass opacity on high-resolution computed tomography with cine-mode display

2010 ◽  
Vol 4 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Michihiro Yamaguchi ◽  
Yuichi Bessho ◽  
Tatsuro Inoue ◽  
Yoshiyuki Asai ◽  
Tomoshige Matsumoto ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
High Resolution Computed Tomography

Oncologic outcomes of segmentectomy versus lobectomy for radiologically aggressive small-sized lung cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8525-8525
Author(s):  
Atsushi Kamigaichi ◽  
Yasuhiro Tsutani ◽  
Takahiro Mimae ◽  
Yoshihiro Miyata ◽  
Kentaro Imai ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Clinical Stage ◽  
Multivariable Analysis ◽  
Standardized Uptake Value ◽  
Ground Glass Opacity ◽  
Oncologic Outcomes ◽  
Smoking History ◽  
High Resolution Computed Tomography ◽  
Significant Difference

8525 Background: Despite increasing evidence of favorable outcomes after segmentectomy for indolent lung cancer, such as ground glass opacity-dominant tumors, the adaptation of segmentectomy for radiologically aggressive lung cancer remains controversial. We attempted to elucidate oncologic outcomes after segmentectomy for radiologically aggressive lung cancer. Methods: Data from a multicenter database of 1353 patients with completely resected clinical Stage IA1–IA2 lung cancer at three institutions were retrospectively analyzed to identify radiologically aggressive lung cancer and compare outcomes of segmentectomy versus lobectomy in patients with radiologically aggressive lung cancer using propensity score matching. Results: Multivariable analysis showed that consolidation to maximum tumor (C/T) ratio on preoperative high-resolution computed tomography ( P= 0.037) and maximum standardized uptake value (SUVmax) on 18-fluorodeoxyglucose positron emission tomography/computed tomography ( P= 0.029) were independent predictors of recurrence-free survival (RFS). The criteria for radiologically aggressive lung cancer were determined as C/T ratio ≥ 0.8 or SUVmax ≥ 2.5, for which 522 patients were identified. RFS and overall survival (OS) were significantly worse in patients with aggressive lung cancer (5-year RFS, 83.3%; 5-year OS, 89.4%) than in those without the same (5-year RFS, 97.0%; P< 0.0001; 5-year OS, 97.3%; P< 0.0001). Among patients with aggressive lung cancer, no significant difference in RFS and OS was found between those undergoing lobectomy (n = 392) (5-year RFS, 81.3%; 5-year OS, 88.3%) and segmentectomy (n = 130) (5-year RFS, 90.0%; P= 0.33; 5-year OS, 92.3%; P= 0.76). Among the 111 pairs propensity matched for age, sex, smoking history, solid tumor size, C/T ratio, SUVmax, tumor location, clinical stage, and histology, similar RFS and OS were found between those undergoing lobectomy (5-year RFS, 83.3%; 5-year OS, 88.3%) and segmentectomy (5-year RFS, 90.9%; P= 0.92; 5-year OS, 94.5%). Conclusions: For radiologically aggressive small-sized lung cancer, oncologic outcomes of segmentectomy were equivalent to those of lobectomy.

scholarly journals Hypersensitivity Pneumonitis with Normal High Resolution Computed Tomography Scans

2001 ◽  
Vol 8 (2) ◽  
pp. 98-101 ◽  
Author(s):  
Farah J Nasser-Sharif ◽  
Meyer S Balter
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lupus Erythematosus ◽  
Hypersensitivity Pneumonitis ◽  
Pulmonary Function Tests ◽  
Open Lung Biopsy ◽  
Ct Scans ◽  
High Resolution Computed Tomography ◽  
High Resolution Ct ◽  
History Of

A case of symptomatic hypersensitivity pneumonitis with normal high resolution computed tomography (CT) scans is presented. The patient, a 32-year-old man with systemic lupus erythematosus, had a chronic, progressive history of respiratory symptoms, abnormal findings on examination and abnormal pulmonary function tests but normal high resolution CT scans of the chest. Diagnosis was made through open lung biopsy. Clinical improvement was seen on removal of the offending antigen. The literature on the utility of high resolution CT scans in hypersensitivity pneumonitis is reviewed.

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