Title: Spectrum of Interstitial Lung Disease on High Resolution Computed Tomography- A Cross-Sectional Analysis

Authors: Dr Madhumita Chandrasekaran, Dr Anand.A.M., Dr Kulasekaran Nadhamuni, Dr Vasanthapriya Janarthanan, Dr Mohamed Rafi Kathar Hussain

 DOI: https://dx.doi.org/10.18535/jmscr/v9i2.31

Abstract

Introduction

Interstitial lung disease (ILD) which is also known as diffuse infiltrative lung disease is a group of disorders which includes more than 200 entities mainly affecting the pulmonary interstitium in the lung parenchyma1. Pulmonary interstitium is the network of connective tissue fibers that supports the lung which includes interlobular septa, alveolar walls, and the peri-bronchovascular interstitium. It is characterized by interlobular/ interlobularseptal thickening, fibroblast proliferation, and pulmonaryfibrosis1

Clinically they most commonly present with shortness of breath, dry cough, fatigue, and discomfort in the chest. The chest radiograph which is the initial imaging modality shows diffuse interstitial patterns like reticular, nodular, or reticulonodular opacities.  In about 10 to 20 % of patients, a chest radiograph was found to be normal, even though lung biopsy was found to be positive2. Hence high resolution computed tomography of thorax is important in early diagnosis of interstitial lung disease with the assessment of its types and severity.

References

  1. Bhat IM, Bhat JA, Shamshad M, Malik AA, Mir S. Role of High- resolution Computed Tomography Chest in Interstitial Lung Diseases. Int J Sci Stud2016;4(2):20-6.
  2. Heitzman ER, Markarian B, Berger I, Dailey E. The secondary pulmonary lobule: a practical concept for interpretation of chest radiographs. II. Application of the anatomic concept to an understanding of roentgen pattern in disease states. Radiology.1969; 93:513-19.
  3. The ILD India Registry: A novel tool for epidemiological surveillance of interstitial lung disease in India. Indian J Chest Dis Allied Sci2013;55:197-99.
  4. Padley SP, Adler B, Muller NL. HRCT of the chest current indications. J Thoracic Imaging 1992; 8: 189 -99.
  5. Mathieson JR, Mayo JR, Staples CA, et al. Chronic diffuse infiltrative lung disease: comparison of diagnostic accuracy of CT and chest radiography. Radiol 1989; 171: 111-16.
  6. Raugh G, Mageto YN, Lockhart D, Schmidt RA, Wood DE, Godwin JD. The accuracy of the clinical diagnosis of new-onset IPF and other interstitial lung disease: A prospective study. Chest  1999; 116: 1168 -74.
  7. Nishirmurak KM, Izumi T, Nagai.UIP histologic correlation with HRCT Radiology 1992; 182: 337-42.
  8. Swensen Sm Aughebbangh G, Myers J. Diffuse lung disease. Diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung. Radiol 1997; 205: 229 -34.
  9. Mac-Donald SL, Rubens MB, Hansell DM, et al. NSIP and UIP comparative appearance and diagnostic accuracy of HRCT. Radiol 2001;221:600 -5.
  10. Faria IM, Zanetti G, Barreto MM, et al. Organizing pneumonia: chest HRCT findings. J Bras Pneumol. 2015;41(3):231-7. doi:10.1590/S1806-37132015000004544.
  11. Hansell DM, Moskovic E. High resolution computed tomography in extrinsic allergic alveoli is. Clin Radiol.1991;43:8-12.
  12. Beddy P, Babar J, Devaraj A. A practical approach to cystic lung disease on HRCT. Insights Imaging. 2011;2(1):1-7. doi:10.1007/s13244-010-0050-7.
  13. Hartman TE, Primack SL, Kang EY, Swensen SJ, Hansell DM, Muller NL. Disease progression in usual interstitial pneumonia compared to desqumative interstitial pneumonia. Assessment with serial CT. Chest 1996; 110:378-82.

Corresponding Author

Dr Madhumita Chandrasekaran

Post Graduate, Department of Radiodiagnosis, Sri Manakula Vinayagar Medical College and Hospital, Madagadipet, Puducherry