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Thoracic Imaging |
1 From Dept of Radiology, Vancouver Hospital and Health Sciences Centre, 855 W 12th Ave, Vancouver, BC, Canada V5Z 1M9 (T.J., N.L.M., Y.C., P.V.K.); Dept of Radiology, Mayo Clinic, Rochester, Minn (T.E.H.); Dept of Radiology, National Kinki Chuo Hospital for Chest Disease, Osaka, Japan (M. Akira); First Dept of Internal Medicine, Kumamoto University School of Medicine, Japan (K.I., M. Ando); Dept of Radiology, Osaka University Medical School (H.N.). Received May 15, 1998; revision requested Jul 13; revision received Aug 8; accepted Oct 26. Address reprint requests to N.L.M.
PURPOSE: To determine whether idiopathic interstitial pneumonias can be differentiated on the basis of the pattern and distribution of abnormalities at thin-section computed tomography (CT).
MATERIALS AND METHODS: Thin-section CT scans in 129 patients with histologically proved idiopathic interstitial pneumonia (35 with usual interstitial pneumonia [UIP], 24 with bronchiolitis obliterans organizing pneumonia [BOOP], 23 with desquamative interstitial pneumonia [DIP], 20 with acute interstitial pneumonia [AIP], and 27 with nonspecific interstitial pneumonia and fibrosis [NIPF]) were independently assessed by two observers without knowledge of clinical or histologic data. The observers recorded the abnormalities, diagnosis, and degree of confidence in their diagnosis. Differential diagnosis was limited to the five types of idiopathic interstitial pneumonia.
RESULTS: The two observers made a correct diagnosis, on average, in 74 (57%) cases. On average, the correct diagnosis was made in 25 (71%) cases of UIP, 19 (79%) of BOOP, 14.5 (63%) of DIP, 13 (65%) of AIP, and 2.5 (9%) of NIPF. The two observers made a correct diagnosis with a high degree of confidence in 50 (39%) readings. There was moderate agreement between the observers for the correct diagnosis (
= 0.55) and for the correct diagnosis with a high degree of confidence ( = 0.65).
CONCLUSION: Except for NIPF, the various subtypes of idiopathic interstitial pneumonias often have a characteristic appearance that allows differentiation at thin-section CT.
Index terms: Bronchiolitis obliteratns organizing pneumonia, 60.2191 • Lung, CT, 60.12111, 60.12118 • Pneumonia, acute interstitial, 60.7921 • Pneumonia, desquamative interstitial, 60.793 • Pneumonia, nonspecific interstitial and fibrosis, 60.7922 • Pneumonia, usual interstitial, 60.792
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