Imaging in the diagnosis and management of fibrosing interstitial lung diseases.

IF 2.3 Q2 RESPIRATORY SYSTEM Breathe Pub Date : 2024-03-01 Epub Date: 2024-05-14 DOI:10.1183/20734735.0006-2024
Christoph Lederer, Monika Storman, Adam Domonkos Tarnoki, David Laszlo Tarnoki, George A Margaritopoulos, Helmut Prosch
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Abstract

High-resolution computed tomography (HRCT) plays a pivotal role in the diagnosis and management of interstitial lung diseases (ILDs), particularly given the approval of antifibrotic agents for conditions like idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. Diagnosing fibrotic pulmonary disorders through HRCT involves a detailed and methodical examination. The identification of specific lung tissue changes, including ground-glass opacities and reticulation, along with signs of fibrosis like honeycombing, traction bronchiectasis and lung volume loss, establishes clear HRCT patterns indicative of various ILDs. The reliability of these patterns in predicting pathological conditions depends largely on the clinical context. For instance, when a usual interstitial pneumonia pattern is present, the predictive value of this diagnosis is so high that a lung biopsy is considered to be redundant. This review intends to delineate the HRCT signs of fibrosis, elucidate the specific radiological patterns of fibrotic lung diseases, and identify the clinical circumstances under which these patterns emerge. Additionally, we introduce and discuss novel imaging techniques that hold promise for the diagnosis, screening and early detection of ILDs.

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纤维化间质性肺疾病诊断和治疗中的成像技术。
高分辨率计算机断层扫描(HRCT)在间质性肺疾病(ILDs)的诊断和治疗中发挥着举足轻重的作用,特别是鉴于抗纤维化药物已被批准用于特发性肺纤维化和进行性肺纤维化等疾病的治疗。通过 HRCT 诊断肺纤维化疾病需要进行详细而有条理的检查。通过识别特定的肺组织变化,包括磨玻璃不透明和网状结构,以及纤维化的迹象,如蜂窝、牵引性支气管扩张和肺容积减少,可以建立明确的 HRCT 模式,指示各种 ILD。这些模式预测病理状况的可靠性在很大程度上取决于临床环境。例如,当出现通常的间质性肺炎模式时,这种诊断的预测价值非常高,以至于肺活检被认为是多余的。本综述旨在描述纤维化的 HRCT 征象,阐明纤维化肺部疾病的特定放射学模式,并确定出现这些模式的临床情况。此外,我们还将介绍和讨论有望用于 ILD 诊断、筛查和早期检测的新型成像技术。
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来源期刊
Breathe
Breathe RESPIRATORY SYSTEM-
CiteScore
2.90
自引率
5.00%
发文量
51
审稿时长
12 weeks
期刊最新文献
An elderly woman with acute respiratory failure and diffuse pulmonary changes. Con: indwelling pleural catheters cause harm to patients. Erratum: "Steroids in severe community-acquired pneumonia". S. Ananth, A.G. Mathioudakis, J. Hansel. Breathe 2024; 20: 240081. Highlights from the Respiratory Failure and Mechanical Ventilation Conference 2024. Integration of lung function data: turning snapshots into stories.
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