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High-resolution computed tomography of the lungs: the borderlands of normality

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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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References

  1. Muller NL (2002) Computer tomography and magnetic resonance imaging: past, present and future. Eur Respir J 19:3S–12S

    Google Scholar 

  2. Kazerooni EA (2001) High-resolution CT of the lungs AJR Am J Roentgenol 177:501–519

    PubMed  CAS  Google Scholar 

  3. 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

    PubMed  CAS  Google Scholar 

  4. 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

    Google Scholar 

  5. 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

    PubMed  CAS  Google Scholar 

  6. 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

    PubMed  CAS  Google Scholar 

  7. 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

    PubMed  CAS  Google Scholar 

  8. Leung AN, Miller RR, Muller NL (1993) Parenchymal opacification in chronic infiltrative lung diseases: CT-pathologic correlation. Radiology 188:209–214

    PubMed  CAS  Google Scholar 

  9. Kang EY, Miller RR, Muller NL (1995) Bronchiectasis: comparison of preoperative thin-section CT and pathologic findings in resected specimens. Radiology 195:649–654

    PubMed  CAS  Google Scholar 

  10. Muller NL, Miller RR (1995) Diseases of the bronchioles: CT and histopathologic findings. Radiology 196:3–12

    PubMed  CAS  Google Scholar 

  11. Webb WR (1991) High resolution lung computed tomography: normal and anatomic pathologic findings. Radiol Clin North Am 29:1051–1063

    PubMed  CAS  MathSciNet  Google Scholar 

  12. Griffin CB, Primack SL (2001) High-resolution CT: normal anatomy, techniques, and pitfalls. Radiol Clin North Am 39:1073–90, v

    PubMed  CAS  Google Scholar 

  13. 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

    PubMed  CAS  Google Scholar 

  14. Kirkwood BR (1998) Essential of Medical Statistics. London: Blackwell Science

  15. 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

    CAS  Google Scholar 

  16. 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

    PubMed  CAS  Google Scholar 

  17. Koh DM, Hansell DM (2000) Computed tomography of diffuse interstitial lung disease in children. Clin Radiol 55:659–667

    PubMed  CAS  Google Scholar 

  18. 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

    PubMed  CAS  Google Scholar 

  19. 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

    PubMed  Google Scholar 

  20. Collins J, Stern EJ (1997) Ground-glass opacity at CT: the ABCs. AJR Am J Roentgenol 169:355–367

    PubMed  CAS  Google Scholar 

  21. 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

    CAS  Google Scholar 

  22. Webb WR, Stern EJ, Kanth N, Gamsu G (1993) Dynamic pulmonary CT: findings in healthy adult men. Radiology 186:117–124

    PubMed  CAS  Google Scholar 

  23. Thurlbeck WM, Angus GE (1975) Growth and aging of the normal human lung. Chest 67:3S–7S

    PubMed  CAS  Google Scholar 

  24. Janssens JP, Pache JC, Nicod LP (1999) Physiological changes in respiratory function associated with ageing. Eur Respir J 13:197–205

    PubMed  CAS  Google Scholar 

  25. 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

    PubMed  Google Scholar 

  26. Aberle DR, Gamsu G, Ray CS, Feuerstein IM (1988) Asbestos-related pleural and parenchymal fibrosis: detection with high resolution CT. Radiology 166:729–734

    PubMed  CAS  Google Scholar 

  27. Otake S, Takahashi M, Ishigaki T (2002) Focal pulmonary interstitial opacities adjacent to thoracic spine osteophytes. AJR Am J Roentgenol 179:893–896

    PubMed  Google Scholar 

  28. 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

    PubMed  Google Scholar 

  29. 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

    PubMed  CAS  Google Scholar 

  30. 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

    PubMed  Google Scholar 

  31. 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

    PubMed  CAS  Google Scholar 

  32. 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

    PubMed  CAS  Google Scholar 

  33. 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

    PubMed  Google Scholar 

  34. 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

    PubMed  CAS  Google Scholar 

  35. 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

    PubMed  CAS  Google Scholar 

  36. 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

    PubMed  CAS  Google Scholar 

  37. 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

    PubMed  Google Scholar 

  38. 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

    PubMed  CAS  Google Scholar 

  39. 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

    Google Scholar 

  40. 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

    PubMed  Google Scholar 

  41. 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

    PubMed  CAS  Google Scholar 

  42. 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

    Article  PubMed  CAS  Google Scholar 

  43. 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

    PubMed  CAS  Google Scholar 

  44. 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

    Google Scholar 

  45. 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

    PubMed  CAS  Google Scholar 

  46. 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

    PubMed  CAS  Google Scholar 

  47. 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

    Article  PubMed  CAS  Google Scholar 

  48. 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

    PubMed  CAS  Google Scholar 

  49. 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

    Article  PubMed  CAS  Google Scholar 

  50. Hansell DM, Nicholson AG (2004) Smoking related parenchymal lung disease: HRCT-pathologic correlation. Semin Respir Crit Care Med 24:377–391

    Google Scholar 

  51. Guckel C, Hansell DM (1998) Imaging the 'dirty lung'-has high resolution computed tomography cleared the smoke? Clin Radiol 53:717–722

    PubMed  CAS  Google Scholar 

  52. Desai SR, Ryan SM, Colby TV (2003) Smoking-related interstitial lung diseases: histopathological and imaging perspectives. Clin Radiol 58:259–268

    PubMed  CAS  Google Scholar 

  53. Selman M (2003) The spectrum of smoking-related interstitial lung disorders. Chest 124:1185–1186

    PubMed  Google Scholar 

  54. 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

    PubMed  CAS  Google Scholar 

  55. 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

    PubMed  Google Scholar 

  56. 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

    PubMed  CAS  Google Scholar 

  57. Chabat F, Yang GZ, Hansell DM (2003) Obstructive lung diseases: texture classification for differentiation at CT. Radiology 228:871–877

    PubMed  Google Scholar 

  58. 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

    PubMed  CAS  Google Scholar 

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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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