Fleischner Society: Glossary of Terms for Thoracic Imaging

Hansell, David M.; Bankier, Alexander A.; MacMahon, Heber; McLoud, Theresa C.; Müller, Néstor L.; Rémy, Jacques

doi:10.1148/radiol.2462070712

Cited by 3,522 publications

(2,963 citation statements)

References 136 publications

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“…First, prereading of all images was performed (by KT and KI). Based on this prereading and the established imaging components of thoracic CT scans (21,22), the items to be studied were determined.…”

Section: Methodsmentioning

confidence: 99%

“…After 3 pulmonologists reached consensus on the definitions of these components by referring to the literature (21,22) and discussing both representative and controversial images, all sets of CT images were read independently for the presence/ absence of these components. Finally, CT images were read again by 3 pulmonologists, and consensus was reached by discussing the presence or absence of these components in individual patients.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

Yamagata

Ikeda

Tsushima

et al. 2016

Arthritis & Rheumatology

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Objective. To determine the prevalence of lung abnormalities on chest computed tomography (CT) in patients with microscopic polyangiitis (MPA), to assess the responsiveness of such abnormalities to initial treatment, and to assess associations between these abnormalities and patient and disease characteristics and mortality.Methods. We retrospectively identified 167 consecutive hospital-based patients with MPA in 3 hospitals in Japan. We longitudinally collected clinical information for 150 of these patients, for whom CT images obtained before treatment were available. We then determined the presence of 22 imaging components of lung abnormalities in these patients.Results. The vast majority of patients (97%) had at least 1 lung abnormality on chest CT images, including interstitial lung lesions (66%), airway lesions (66%), pleural lesions (53%), and emphysematous lesions (37%). In multivariate analyses, ground-glass opacity was associated with the Birmingham Vasculitis Activity Score, whereas 3 of 4 airway lesions were associated with myeloperoxidase-antineutrophil cytoplasmic antibodies. Latent class analysis identified a distinct group of patients with airwaypredominant lung lesions. Airway lesions such as bronchiolitis and bronchovascular bundle thickening were among the components that showed improvement within 3 months of the initial treatment. An idiopathic pulmonary fibrosis pattern was the only chest CT variable that was independently associated with shorter survival.Conclusion. Abnormalities in a wide range of anatomic areas, including the whole airway, can be identified in the lungs of patients with MPA before treatment. The prevalence, clustering patterns, and responsiveness to treatment of individual lung abnormalities provide groundwork for informing future studies to understand the pathophysiology of MPA.Microscopic polyangiitis (MPA) is a necrotizing systemic vasculitis that affects small to medium-sized vessels. In MPA, immune deposits on the vessel wall are usually absent, and serum antineutrophil cytoplasmic antibodies (ANCAs) are frequently present. MPA shares these

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

Yamagata

Ikeda

Tsushima

et al. 2016

Arthritis & Rheumatology

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“…The individual lung parenchymal changes were preferentially defined according to the criteria of the "Fleischner Society's glossary of terms" [11]: Nodules of up to 3 cm were included and classified as consolidations. An increase in the density of the lung parenchyma with still recognizable vascular structures was defined as a ground-glass change.…”

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confidence: 99%

CT-Morphological Characterization of Respiratory Syncytial Virus (RSV) Pneumonia in Immune-Compromised Adults

Mayer

Lehners

Egerer

et al. 2014

Fortschr Röntgenstr

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!Purpose: Characterization and follow-up evaluation of chest CT of RSV pneumonia in immune-compromised adults during a seasonal epidemic. Materials and Methods: Retrospective analysis of 132 chest CT examinations of 51 adult immune-compromised patients (29 m/22f, Ø58 years) with clinical signs of pneumonia and positive RSV test in winter 2011/2012. Two experienced chest radiologists evaluated the morphology (bronchial wall thickening, tree-in-bud, nodules, halo, ground-glass opacities, consolidations, pleural fluid) of the CT scans by consensus. Results: Pathological findings were in 86 % of the chest CT scans: Areas of ground-glass attenuation in 64 %, consolidations in 56 %, nodules in 55 % (Ø 8 mm in maximal diameter, with halo in 71 %), pleural fluid in 44 % (Ø 2 cm), tree-in-bud in 36 %, bronchial wall thickening in 27 % and more than one morphological finding in 72 %. There were no pathological CT findings in 14 % of patients with clinical symptoms of pneumonia because these patients did not undergo follow-up. Radiological progression was found in 45 % of patients and regression in 33 % in follow-up examinations. In 37 % an additional examination of the paranasal sinuses was performed and showed sinusitis in 63 % of cases. 90 % of the patients had sinusitis as well as pneumonia. In addition to RSV, a further pathogenic agent was found in bronchoalveolar lavage of five patients (Aspergillus spec., herpes simplex virus, Pseudomonas aeruginosa). Conclusion: The most characteristic signs in chest CT scans were at the beginning of pneumonia with nodules and tree-in-bud often combined with bronchial wall thickening. The following CT scans showed characteristic but not pathognomonic chest CT findings of RSV pneumonia. These morphological findings should be recognized seasonally (winter) especially at the beginning of the case of pneumonia. RSVassociated additional sinusitis is probably common and should be noticed. Key Points:▶ The most characteristic signs in chest CT scans were at the beginning of RSV pneumonia with nodules and tree-in-bud; we suppose that the pneumonia is run through different CT morphological phases.▶ The following CT scans showed less characteristic and multiple CT variations most frequently ground glass and nodules.▶ Negative thoracic CT were seen only in a little part of RSV positive patients with symptoms of pneumonia.

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“…Each CT finding was defined according to the Fleischner Society glossary of terms 17. Pleural effusion was defined based on the presence of pleural fluid with a thickness of ≥1 cm from the parietal pleura.…”

Section: Methodsmentioning

confidence: 99%

High‐dose steroid therapy for acute respiratory distress syndrome lacking common risk factors: predictors of outcome

Kinoshita

Ishii

Kushima

et al. 2017

Acute Medicine & Surgery

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AimAcute respiratory distress syndrome (ARDS) is a life‐threatening lung disease that usually occurs in patients with the underling risk factors that triggers lung inflammation. We sometimes encounter patients with ARDS lacking common risk factors. Recent studies have indicated the effectiveness of corticosteroids for this cohort. However, the characteristics of survivors with ARDS who lack common risk factors, and who received high‐dose methylprednisolone pulse therapy (MPPT), are not known.MethodsWe undertook a retrospective study of patients with ARDS lacking common risk factors, who received i.v. MPPT for 3 days. The patients (n = 46) were classified into two groups, survivors (n = 23) and non‐survivors (n = 23), based on their survival at 60 days after the initiation of MPPT, and their clinical and radiological parameters were evaluated.ResultsThe patient characteristics and disease severity of the two groups were comparable. The percentage of consolidation/(ground‐glass attenuation [GGA] + consolidation) on the chest computed tomography scans of survivors was significantly lower than that of non‐survivors (survivors, 5.63% [2.31–13.8] versus non‐survivors, 27.2% [5.97–41.4]; P = 0.01). In the stratified analysis, the percentage of consolidation/(GGA + consolidation) was significantly associated with 60‐day survival.ConclusionsOur results show that the percentage of consolidation/(GGA + consolidation) on the chest CT scans is an independent prognostic factor for patients with ARDS lacking common risk factors after MPPT.

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Fleischner Society: Glossary of Terms for Thoracic Imaging

Cited by 3,522 publications

References 136 publications

Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

Prevalence and Responsiveness to Treatment of Lung Abnormalities on Chest Computed Tomography in Patients With Microscopic Polyangiitis: A Multicenter, Longitudinal, Retrospective Study of One Hundred Fifty Consecutive Hospital‐Based Japanese Patients

CT-Morphological Characterization of Respiratory Syncytial Virus (RSV) Pneumonia in Immune-Compromised Adults

High‐dose steroid therapy for acute respiratory distress syndrome lacking common risk factors: predictors of outcome

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