Abstract
High-resolution computed tomography (HRCT) is now widely used in the assessment of airways and diffuse lung disease. Considerable literature on pathologic correlation has increased the understanding of the signs of disease seen on HRCT. However, neither the significance of subtle individual signs nor the spectrum of HRCT appearances in healthy lungs is well documented. HRCT signs that cause diagnostic uncertainty and the spectrum of findings that exist between definite normality and definite abnormality are discussed.
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Muller NL (2002) Computer tomography and magnetic resonance imaging: past, present and future. Eur Respir J 19:3S–12S
Kazerooni EA (2001) High-resolution CT of the lungs AJR Am J Roentgenol 177:501–519
Remy-Jardin M, Remy J, Deffontaines C, Duhamel A (1991) Assessment of diffuse infiltrative lung disease: comparison of conventional CT and high-resolution CT. Radiology 181:157–162
Padley SPG, Hansell DM, Flower CDR, Jennings P (1991) Comparative accuracy of high resolution computed tomography and chest radiography in the diagnosis of chronic diffuse infiltrative lung disease. Clin Radiol 44:227–231
Lee KS, Primack SL, Staples CA, Mayo JR, Aldrich JE, Muller NL (1994) Chronic infiltrative lung disease: comparison of diagnostic accuracies of radiography and low- and conventional-dose thin- section CT. Radiology 191:669–673
Leung AN, Staples CA, Muller NL (1991) Chronic diffuse infiltrative lung disease: comparison of diagnostic accuracy of High-resolution and Conventional CT. AJR Am J Roentgenol 157:693–696
Copley SJ, Coren M, Nicholson AG, Rubens MB, Bush A, Hansell DM (2000) Diagnostic accuracy of thin-section CT and chest radiography of pediatric interstitial lung disease. AJR Am J Roentgenol 174:549–554
Leung AN, Miller RR, Muller NL (1993) Parenchymal opacification in chronic infiltrative lung diseases: CT-pathologic correlation. Radiology 188:209–214
Kang EY, Miller RR, Muller NL (1995) Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens. Radiology 195:649–654
Muller NL, Miller RR (1995) Diseases of the bronchioles: CT and histopathologic findings. Radiology 196:3–12
Webb WR (1991) High resolution lung computed tomography: normal and anatomic pathologic findings. Radiol Clin North Am 29:1051–1063
Griffin CB, Primack SL (2001) High-resolution CT: normal anatomy, techniques, and pitfalls. Radiol Clin North Am 39:1073–90, v
Lee KW, Chung SY, Yang I, Lee Y, Ko EY, Park MJ (2000) Correlation of aging and smoking with air trapping at thin-section CT of the lung in asymptomatic subjects. Radiology 214:831–836
Kirkwood BR (1998) Essential of Medical Statistics. London: Blackwell Science
Remy-Jardin M, Remy J, Giraud F, Wattinne L, Gosselin B (1993) Computed tomography (CT) assessment of ground-glass opacity: semiology and significance. J Thorac Imag 8:249–264
Austin JHM, Muller NL, Friedman PJ, Hansell DM, Naidich DP, Remy-Jardin M, Webb WR, Zerhouni EA, Austin JH (1996) Glossary of terms for CT of the lungs: recommendations of the nomenclature committee of the Fleischner Society. Radiology 200:327–331
Koh DM, Hansell DM (2000) Computed tomography of diffuse interstitial lung disease in children. Clin Radiol 55:659–667
Jang HJ, Lee KS, Kwon OJ, Rhee CH, Shim YM, Han J (1996) Bronchioloalveolar carcinoma: focal area of ground-glass attenuation at thin-section CT as an early sign. Radiology 199:485–488
Kodama T, Higashiyama M, Yokouchi H, Takami K, Kuriyama K, Kusunoki Y, Nakayama T, Imamura F (2002) Natural history of pure ground glass opacity after long-term follow-up of more than 2 years. Ann Thorac Surg 73:386–393
Collins J, Stern EJ (1997) Ground-glass opacity at CT: the ABCs. AJR Am J Roentgenol 169:355–367
Zerhouni EA, Naidich DP, Stitik FP, Khouri NF, Siegelman SS (1985) Computed tomography of the pulmonary parenchyma. Part 2: Interstitial disease. J Thorac Imag 1:54–64
Webb WR, Stern EJ, Kanth N, Gamsu G (1993) Dynamic pulmonary CT: findings in healthy adult men. Radiology 186:117–124
Thurlbeck WM, Angus GE (1975) Growth and aging of the normal human lung. Chest 67:3S–7S
Janssens JP, Pache JC, Nicod LP (1999) Physiological changes in respiratory function associated with ageing. Eur Respir J 13:197–205
Nakata M, Saeki H, Takata I, Segawa Y, Mogami H, Mandai K, Eguchi K (2002) Focal ground-glass opacity detected by low-dose helical CT. Chest 121:1464–1467
Aberle DR, Gamsu G, Ray CS, Feuerstein IM (1988) Asbestos-related pleural and parenchymal fibrosis: detection with high resolution CT. Radiology 166:729–734
Otake S, Takahashi M, Ishigaki T (2002) Focal pulmonary interstitial opacities adjacent to thoracic spine osteophytes. AJR Am J Roentgenol 179:893–896
Nomori H, Ohtsuka T, Naruke T, Suemasu K (2003) Differentiating between atypical adenomatous hyperplasia and bronchioloalveaolar carcinoma using the computed tomography number histogram. Ann Thorac Surg 76:867–871
Kawakami S, Sone S, Takashima S, Li F, Yang ZG, Maruyama Y, Honda T, Hasegawa M, Wang JC (2001) Atypical adenomatous hyperplasia of the lung: correlation between high-resolution CT findings and histopathologic features. Eur Radiol 11:811–814
Kakinuma R, Ohmatsu H, Kaneko M, Kusumoto M, Yoshida J, Nagai K, Nishiwaki Y, Kobayashi T, Tsuchiya R, Nishiyama H, Matsui E, Eguchi K, Moriyama N (2004) Progression of focal pure ground-glass opacity detected by low-dose helical computed tomography screening for lung cancer. J Comput Assist Tomogr 28:17–23
Chen D, Webb WR, Storto ML, Lee KN (1998) Assessment of air trapping using postexpiratory high-resolution computed tomography. J Thorac Imaging 13:135–143
Verschakelen JA, Scheinbaum K, Bogaert J, Demedts M, Lacquet LL, Baert AL (1998) Expiratory CT in cigarette smokers: correlation between areas of decreased lung attenuation, pulmonary function tests and smoking history. Eur Radiol 8:1391–1399
Tanaka N, Matsumoto T, Miura G, Emoto T, Matsunaga N, Ueda K, Lynch DA (2003) Air trapping at CT: high prevalence in asymptomatic subjects with normal pulmonary function. Radiology 227:776–785
Park CS, Muller NL, Worthy SA, Kim JS, Awadh N, Fitzgerald M (1997) Airway obstruction in asthmatic and healthy individuals: inspiratory and expiratory thin-section CT findings. Radiology 203:361–367
Lucidarme O, Coche E, Cluzel P, Mourey-Gerosa I, Howarth N, Grenier P (1998) Expiratory CT scans for chronic airway disease: correlation with pulmonary function test results. AJR Am J Roentgenol 170:301–307
Mastora I, Remy-Jardin M, Sobaszek A, Boulenguez C, Remy J, Edme JL (2001) Thin-section CT finding in 250 volunteers: assessment of the relationship of CT findings with smoking history and pulmonary function test results. Radiology 218:695–702
Choi YW, Rossi SE, Palmer SM, Delong D, Erasmus JJ, McAdams HP (2003) Bronchiolitis obliterans syndrome in lung transplant recipients: correlation of computed tomography findings with bronchiolitis obliterans syndrome stage. J Thorac Imaging 18:72–79
Munden RF, Hess KR (2001) “Ditzels” on chest CT: survey of members of the Society of Thoracic Radiology. AJR Am J Roentgenol 176:1363–1369
Vikgren J, Boijsen M, Andelid K, Ekberg-Jansson A, Larsson S, Bake B, Tylen U (2004) High-resolution computed tomography in healthy smokers and never-smokers: a 6-year follow-up study of men born in 1933. Acta Radiol 1:44–52
Marchac V, Emond S, Mamou-Mani T, Bihan-Benjamin C, Le Bourgeois M, de Blic J, Scheinmann P, Brunelle F (2002) Thoracic CT in pediatric patients with difficult-to-treat asthma. AJR Am J Roentgenol 179:1245–1252
Reittner P, Muller NL, Heyneman L, Johkoh T, Park JS, Lee KS, Honda O, Tomiyama N (2000) Mycoplasma pneumoniae pneumonia: radiographic and high-resolution CT features in 28 patients. AJR Am J Roentgenol 174:37–41
Gono H, Fujimoto K, Kawakami S, Kubo K (2003) Evaluation of airway wall thickness and air trapping by HRCT in asymptomatic asthma. Eur Respir J 22:965–971
Ketai L, Coutsias C, Williamson S, Coutsias V (2001) Thin-section CT evidence of bronchial thickening in children with stable asthma: bronchoconstriction or airway remodeling? Acad Radiol 8:257–264
Matsuoka S, Uchiyama K, Shima H, Ueno N, Oish S, Nojiri Y (2002) Bronchoarterial ratio and bronchial wall thickness in high-resolution CT in asymptomatic subjects: correlation with age and smoking. AJR Am J Roentgenol 180:513–518
Bankier AA, Fleischmann D, Mallek R, Windisch A, Winkelbauer FW, Kontrus M, Havelec L, Herold CJ, Hubsch P (1996) Bronchial wall thickness: appropriate window settings for thin- section CT and radiologic-anatomic correlation. Radiology 199:831–836
Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology 188:829–833
Awadh N, Muller NL, Park CS, Abboud RT, FitzGerald JM (1998) Airway wall thickness in patients with near fatal asthma and control groups: assessment with high resolution computed tomographic scanning. Thorax 53:248–253
Heard BE, Khatchatourov V, Otto H, Putov NV, Sobin L (1979) The morphology of emphysema, chronic bronchitis, and bronchiectasis: definition, nomenclature, and classification. J Clin Pathol 32:882–892
Kim SJ, Im JG, Kim IO, Cho ST, Cha SH, Park KS, Kim DY (1995) Normal bronchial and pulmonary arterial diameters measured by thin section CT. J Comput Assist Tomogr 19:365–369
Hansell DM, Nicholson AG (2004) Smoking related parenchymal lung disease: HRCT-pathologic correlation. Semin Respir Crit Care Med 24:377–391
Guckel C, Hansell DM (1998) Imaging the 'dirty lung'-has high resolution computed tomography cleared the smoke? Clin Radiol 53:717–722
Desai SR, Ryan SM, Colby TV (2003) Smoking-related interstitial lung diseases: histopathological and imaging perspectives. Clin Radiol 58:259–268
Selman M (2003) The spectrum of smoking-related interstitial lung disorders. Chest 124:1185–1186
Remy-Jardin M, Remy J, Boulenguez C, Sobaszek A, Edme JL, Furon D (1993) Morphologic effects of cigarette smoking on airways and pulmonary parenchyma in healthy adult volunteers: CT evaluation and correlation with pulmonary function tests. Radiology 186:107–115
Remy-Jardin M, Edme JL, Boulenguez C, Remy J, Mastora I, Sobaszek A (2002) Longitudinal follow-up study of smoker's lung with thin-section CT in correlation with pulmonary function tests. Radiology 222:261–270
Tylen U, Boijsen M, Ekberg-Jansson A, Bake B, Lofdahl CG (2000) Emphysematous lesions and lung function in healthy smokers 60 years of age. Respir Med 94:38–43
Chabat F, Yang GZ, Hansell DM (2003) Obstructive lung diseases: texture classification for differentiation at CT. Radiology 228:871–877
Uppaluri R, Mitsa T, Sonka M, Hoffman EA, McLennan G (1997) Quantification of pulmonary emphysema from lung computed tomography images. Am J Respir Crit Care Med 156:248–254
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Dalal, P.U., Hansell, D.M. High-resolution computed tomography of the lungs: the borderlands of normality. Eur Radiol 16, 771–780 (2006). https://doi.org/10.1007/s00330-005-0040-1
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DOI: https://doi.org/10.1007/s00330-005-0040-1