04 Nov

Computed Tomography of the Pulmonary Parenchyma: Conclusion

There is no doubt that HRCT, with its resolution in the order of 200 μ and its freedom from tissue superimposition, could offer significant advantages over plain radiography. For instance, unlike plain films, HRCT does not require summation of nonresolvable small lesions for effective detection. However, even at 200 p., the resolution of HRCT is […]

03 Nov

Computed Tomography of the Pulmonary Parenchyma: Disease Specific Applications

The last category of signs described in interstitial disease is that of ill-defined patches of increased parenchymal density with a ground-glass appearance that correlate pathologically with diffuse thickening of the interstitium with obliteration of airspaces. Various combinations of the above described basic signs have been reported in specific disease entities such as fibrosing alveolitis. Preliminary […]

02 Nov

Computed Tomography of the Pulmonary Parenchyma: Signs of Interstitial Disease

2. Interstitial nodules. Unlike airspace nodules, interstitial nodules appear sharply marginated on HRCT, and even when profuse, do not coalesce into a single opacity. Nodules as small as 1 mm in diameter can easily be detected, an important advantage over plain radiography. 3. Reticular patterns. Three patterns of interstitial reticulation distinguishable by the size of […]

01 Nov

Computed Tomography of the Pulmonary Parenchyma: Signs of Airspace Disease

Signs of Airspace Disease: Experiments with inflated lungs following intrabronchial injection of fluids and observation of autopsy or clinical cases in airspace disease reveal characteristic appearances evolving into well-defined patterns. The earliest manifestation of an airspace process is the appearance of subtle, poorly marginated nodular densities corresponding to partially filled airspaces within the primary lobule. […]

31 Oct

Computed Tomography of the Pulmonary Parenchyma: CT in the Evaluation of Diffuse Pulmonary Pathology

The Persistent Pulmonary Infiltrate: A focal infiltrate that persists despite presumably effective therapy is a common clinical problem. Excluding the possibility of a proximal obstructive lesion is an essential step in the management of such cases. CT is well suited to such a task as an adjunct to bronchoscopy, which may be hampered by the […]

30 Oct

Computed Tomography of the Pulmonary Parenchyma: Focal Inflammatory Disease

Other lesions have characteristic morphologic presentations. For instance, early focal invasive aspergillosis typically demonstrates a halo of intermediate density corresponding to edema and necrosis of the neighboring parenchyma. In the clinical context of the immunocompromised patient, such an appearance is very suggestive of the diagnosis and of great value in the care of these patients.

29 Oct

Computed Tomography of the Pulmonary Parenchyma: Metastatic Nodules

Metastatic Nodules: CT is clearly the most accurate means of detecting occult metastic lung disease. In the oncologic patient, detection of unsuspected nodules always creates the need to ensure that these lesions are not incidental benign nodules. This is especially important in the oncologic patient, who is generally more prone to pulmonary infections including slow-growing […]

28 Oct

Computed Tomography of the Pulmonary Parenchyma: The Lung Nodule

A less appreciated yet critical role for CT densitometry is its ability to reliably exclude the presence of calcification and thus prompt aggressive management, which would otherwise have been delayed. This is particularly important in the smaller lesions, which tend to be managed conservatively by sequential chest roentgenograms because of the general assumption that small […]

27 Oct

Computed Tomography of the Pulmonary Parenchyma: CT in the Evaluation of Focal Pulmonary Pathology

The Lung Nodule One of the most common clinical problems in thoracic imaging, the pulmonary nodule always presents the challenge of defining as noninvasively as possible its etiology. CT may provide unique density or morphologic information, allowing specific diagnoses to be made in given subgroups of nodules. The Calcified Granuloma: Benign granulomas make up the […]

26 Oct

Computed Tomography of the Pulmonary Parenchyma

An Overview Since its inception in the mid-1970s, computed tomography has played a major role in the evaluation of the mediastinum and to a lesser extent in that of the chest wall and pleura. Adequate evaluations of the pulmonary parenchyma were not possible until the early 1980s, when achievement of short scanning times permitted studies […]

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