The role of HRCT in the differential diagnosis of pulmonary parenchymal opacification

It is the purpose of the study to determinate whether or not HRCT is helpful in making differential diagnosis of patients with multifocal pulmonary parenchyma infiltrative opacification. The HRCT scans of 99 patients, selected on the basis of the presence of multifocal alveolar and/or ground-glass patterns are retrospectively reviewed. They are distributed in 3 groups as follows: group 1 (n=34) - patients with immunologic genesis of the disease where corticosteroids is the treatment of choice, two (n=24) - infectious disease, and three (n=34) - malignant diseases. The presence of 15 different indicator in the scanograms in all patients are analyzed. In group 1 the changes most frequently encountered include the zones with ground glass attenuation, sub-pleural and septal lines, peripheral distribution of the lesions and pleural thickenings. In group two the prevailing changes include acinar nodules, centrilobular branching structures ground-glass attenuation and segmental distribution of the changes. Ground-glass attenuation, air bronchiolograms, air alveolograms, pleural effusions and peribronchovascular bundle thickening are the commonest findings in group 3. In conclusion the assumption is warranted that HRCT affords additional information in diagnosing patients presenting multifocal infiltrative changes in pulmonary parenchyma. The study contributes to gain better insight into the pathomorphological changes and their distribution pattern. (author)