Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans.

Arakawa, Hiroaki; Wr, Webb; McCowin, Marcia; Katsou, Georgia; Lee, K N; Seitz, RS

doi:10.1148/radiology.206.1.9423656

Cited by 114 publications

(49 citation statements)

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“…It is recognized during the expiratory phase as reduced attenuation of the lung parenchyma, especially apparent as lowerthan-usual density ( Figure 1) and absence of volume reduction. (8)(9)(10) See also Mosaic attenuation/perfusion pattern.…”

Section: Glossary 1 Air Trapping (Aprisionamento Aéreo)mentioning

confidence: 99%

“…(62,63) Air trapping secondary to bronchial or bronchiolar obstruction can produce parenchymal foci of lower attenuation, which become more evident in expiratory CT scans. (8) In obliterative small-airways disease and vascular occlusive disease, the areas of low attenuation are abnormal; in general, the number and size of pulmonary vessels in these areas are reduced when compared with those in the adjacent normal lung, which might present normal or increased attenuation (due to redirec-…”

Section: Ground-glass Opacity/attenuation (Opacidade/atenuação Em Vidmentioning

confidence: 99%

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Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax

et al. 2010

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O objetivo deste novo consenso brasileiro é atualizar e dar continuidade à padronização da terminologia dos principais descritores e padrões fundamentais da TC de tórax em língua portuguesa. Este consenso contém uma descrição sucinta dos principais termos utilizados na TC de tórax e ilustrações de exemplos clássicos. O grupo de autores é formado por médicos radiologistas membros do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, especializados em radiologia torácica, e por pneumologistas membros da Sociedade Brasileira de Pneumologia e Tisiologia, com particular interesse em diagnóstico por imagem.

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Section: Glossary 1 Air Trapping (Aprisionamento Aéreo)mentioning

confidence: 99%

Section: Ground-glass Opacity/attenuation (Opacidade/atenuação Em Vidmentioning

confidence: 99%

Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax

et al. 2010

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“…This important sign of enhancement of the mosaic attenuation pattern on CT sections obtained at endexpiration (usually limited to approximately six sections taken between the aortic arch and right hemidiaphragm) has led some workers to suggest that they should be acquired routinely, irrespective of the findings on the standard inspiratory HRCT sections [15,16]. Whether expiratory CT sections need to be obtained in all cases of suspected small airways disease is questionable.…”

Section: High-resolution Computed Tomographic Techniquementioning

confidence: 99%

“…The crosssectional area of the affected parts of the lung do not decrease in size on expiratory CT [91]. Expiratory CT may also be helpful in differentiating between the three main causes of a mosaic pattern (infiltrative lung disease, small airways disease, and occlusive pulmonary vascular disease) which may be problematic on inspiratory CT [15,94]. An important caveat is that in patients with widespread small airways disease, endexpiratory CT sections may appear virtually identical to the standard inspiratory CT sections, simply because of the severity of the air-trapping (i.e.…”

Section: Air-trapping At Expiratory Computed Tomographymentioning

confidence: 99%

Small airways diseases: detection and insights with computed tomography

Dm¹

2001

Eur Respir J

145

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Diseases affecting the small airways are difficult to detect by traditional diagnostic tests. Widespread involvement is needed before symptoms and abnormalities on pulmonary function testing or chest radiography become apparent. Obstruction of the bronchioles may be detected indirectly by computed tomography (CT) because regional under-ventilation results in reduced perfusion which in turn is shown as a mosaic attenuation pattern of the lung parenchyma. When there is inflammation of the bronchioles with accompanying exudate, the airways may become directly visible on CT, for example in cases of diffuse panbronchiolitis.Quantification of the various morphological features of small airways disease is possible from CT images and this increased precision has aided investigations of structure/function relationships.An understanding of the pathology and microscopic distribution of disease in relation to the airways allows some prediction of the likely computed tomography appearances in this wide spectrum of conditions, and thus helps to refine the differential diagnosis.

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“…They found it uniform everywhere at TLC, but there was a vertical gradient of alveolar volume at FRC. Because the tissue density of lung parenchyma is reciprocal to the alveolar volume, their findings indicated that the tissue density is uniform at TLC and gravity-dependent at FRC, which today we can see by inspiratory and expiratory chest CT images [14]. The uniform density at TLC is thought to result from the respiratory muscle power that generates uniform intrathoracic pressure against gravity.…”

mentioning

confidence: 97%

A Novel Interpretation of Closing Volume Based on Single-Breath Nitrogen Washout Curve Simulation

Kitaoka¹,

Kawase²

2007

J. Physiol. Sci

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Abstract:Although closing volume is regarded as a clinical test for the early detection of peripheral airway closure, its grounds are not clear. There have been no simulation studies for phase IV in the single-breath nitrogen washout (SBNW) curve, even though several mathematical models for phase III have been proposed. We modeled the lung tissue deformation during slow expiration in which the tissue was regarded as a porous elastic body similar to a sponge. We assigned the maximum tissue density of lung parenchyma over which the lung tissue could not be contracted according to several experimental reports in literature. SBNW curves were then simulated by computing expired air volume and nitrogen concentration for respective acini in the lung model. The simulated SBNW curves well reproduced phase IV, cardiac oscillation, and its postural changes. We found that the higher lung compliance increased closing volume, but decreased residual volume. The smaller maximum tissue density generated larger closing volume and larger residual volume. It suggested that phase IV reflected the alveolar contractility, and the increase of closing volume in emphysema could be explained by an insufficient contraction of alveoli. We also found that the distribution of maximum tissue density affected the onset of Phase IV. A constant value of density generated a clear onset, but a wide distribution of it corresponding to peripheral airway closure obscured it. We suggest that the airway closure was not necessary for phase IV appearance in both normal and emphysematous lung.

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Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans.

Abstract: Expiratory scans significantly improved diagnostic accuracy in patients with inhomogeneous attenuation on inspiratory scans, and they helped in the diagnosis of diffuse lung disease.

Cited by 114 publications

References 0 publications

Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax

Consenso brasileiro ilustrado sobre a terminologia dos descritores e padrões fundamentais da TC de tórax

Small airways diseases: detection and insights with computed tomography

A Novel Interpretation of Closing Volume Based on Single-Breath Nitrogen Washout Curve Simulation

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