Modelo de interpretação da tomografia computadorizada de alta resolução do diagnóstico diferencial das doenças intersticiais crônicas

Abstract

O reconhecimento e o diagnóstico diferencial dos diversos padrões da tomografia computadorizada de alta resolução (TCAR) são de fundamental importância na avaliação das doenças pulmonares difusas. Existem vários padrões de TCAR descritos na literatura, sendo alguns deles superponíveis. A interpretação desses padrões pode ser uma tarefa difícil, particularmente para residentes e radiologistas não especializados em tórax. Os autores ilustram os achados característicos da TCAR nas doenças pulmonares intersticiais crônicas e propõem um modelo simplificado de interpretação desses achados, baseado no padrão e na distribuição da doença. O algoritmo inclui os seis principais padrões de anormalidade identificados na TCAR: septal, reticular, cístico, nodular, de atenuação em vidro fosco e consolidação parenquimatosa.

Pulmonary involvement in human visceral leishmaniasis: Clinical and tomographic evaluation

“…The radiological study described reticular Table 4. Association between tomographic changes and clinical manifestations of patients admitted with VL at HU-UFS, from January 2015 to July 2018. opacities, ground-glass opacities, and inter-and intra-lobular septal thickening alterations indicative of interstitial pneumonia [18,19]. The results of our study, besides confirming, revealed the high frequency of interstitial involvement in the parasitosis.…”

“…Chest X-ray revealed pneumonia in only two patients in the study, and both reported respiratory symptoms. Nodular tomographic pattern and increased pulmonary opacity found in our sample are considered suggestive of interstitial disease, but may also be due to bacterial infection [17,31]. Thus, the frequency of secondary bacterial pneumonia may be higher than that found on plain radiographs.…”

“…Frosted glass is a finding considered by many authors to correspond to a pre-fibrotic stage of moderate severity. Even though the disease evolution time was longer in patients with tomographic alteration, the honeycombing pattern was not found, considered the most advanced stage of interstitial disease [18,19]. Studies in patients with systemic sclerosis have revealed that this pre-fibrotic stage is potentially reversible when appropriate treatment of underlying disease is instituted [23].…”