Elsevier

Academic Radiology

Volume 18, Issue 11, November 2011, Pages 1453-1460
Academic Radiology

Radiology resident education
Interactive High-resolution Computed Tomography Digital Atlas of Interstitial Lung Disease

https://doi.org/10.1016/j.acra.2011.07.008Get rights and content

High-resolution computed tomography is a necessary tool used in the diagnosis of interstitial lung disease. The interpretation of high-resolution computed tomography can be difficult given the wide spectrum of imaging appearances within the same disease and among different diseases. The authors provide a new educational method to learn about the spectrum of idiopathic interstitial lung disease through the use of a free online digital atlas and review article. This atlas can be downloaded at http://www.seattlechildrens.org/radiologyeducation/ILD.

Section snippets

Image Acquisition and Disease Selection

All HRCT examinations were performed from 2000 through 2010 on a 16-slice or 64-slice scanner. Most studies were performed using a standard HRCT protocol. Axial sections were acquired at 0.625-mm collimation in deep suspended inspiration and reconstructed at 1.5 mm. Images were displayed at a window width of 1000 to 1600 and a mean of −600 to −700. The field of view was approximately 35 cm. Images for the digital atlas were taken at 16 proximate predetermined levels from the inspiratory

UIP

Patients with UIP are usually >50 years of age, with a clinical presentation of slowly progressive dyspnea, nonproductive cough, and weight loss 5, 6, 7. Most patients have a median survival of 2.5 to 3.5 years from symptom onset (8). Lung transplantation may be curative. Histologic analysis reveals normal lung next to fibrotic lung. Within the fibrotic lung is evidence of early and active fibrosis defined by fibroblastic foci as well as dense mature fibrosis indicating a chronic process. The

Conclusions

We have provided a free interactive HRCT digital atlas of varying presentations of ILD and a brief review of ILD. With this software, users are able to test their knowledge of the idiopathic ILDs through the use of unknowns and unlabeled images as described in the appendices. A detailed discussion of the imaging findings and appropriate differential diagnosis accompanies each case. The spectrum of disease is substantial in the same ILD and among the different ILDs. In a future study, we plan to

References (37)

  • J. Chung et al.

    Smoking-related interstitial lung diseases

    Semin Roentgenol

    (2010)
  • P. Grenier et al.

    Chronic diffuse interstitial lung disease: diagnostic value of chest radiography and high-resolution CT

    Radiology

    (1991)
  • E.J. Stern et al.

    High-resolution CT of the Chest: Comprehensive Atlas

    (2009)
  • A.T. Society et al.

    American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias

    Am J Respir Crit Care Med

    (2002)
  • S. Jelacic et al.

    Interactive digital MR atlas of the pediatric brain

    Radiographics

    (2006)
  • C. Carrington et al.

    Natural history and treated course of usual and desquamative interstitial pneumonia

    N Engl J Med

    (1978)
  • American Thoracic Society

    Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS)

    Am J Respir Crit Care Med

    (2000)
  • N. Müller et al.

    Differential diagnosis of bronchiolitis obliterans with organizing pneumonia and usual interstitial pneumonia: clinical, functional, and radiologic findings

    Radiology

    (1987)
  • J. Bjoraker et al.

    Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis

    Am J Respir Crit Care Med

    (1998)
  • T.J. King et al.

    Idiopathic pulmonary fibrosis: relationship between histopathologic features and mortality

    Am J Respir Crit Care Med

    (2001)
  • A. Katzenstein et al.

    Idiopathic pulmonary fibrosis: clinical relevance of pathologic classification

    Am J Respir Crit Care Med

    (1998)
  • K. Nishimura et al.

    Usual interstitial pneumonia: histologic correlation with high-resolution CT

    Radiology

    (1992)
  • T. Johkoh et al.

    Idiopathic interstitial pneumonias: diagnostic accuracy of thin-section CT in 129 patients

    Radiology

    (1999)
  • K. Flaherty et al.

    Radiological versus histological diagnosis in UIP and NSIP: survival implications

    Thorax

    (2003)
  • W. Travis et al.

    Idiopathic nonspecific interstitial pneumonia: prognostic significance of cellular and fibrosing patterns: survival comparison with usual interstitial pneumonia and desquamative interstitial pneumonia

    Am J Surg Pathol

    (2000)
  • O. Nishiyama et al.

    Serial high resolution CT findings in nonspecific interstitial pneumonia/fibrosis

    J Comput Assist Tomogr

    (2000)
  • J. Park et al.

    Nonspecific interstitial pneumonia with fibrosis: radiographic and CT findings in seven patients

    Radiology

    (1995)
  • T. Kim et al.

    Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings

    AJR Am J Roentgenol

    (1998)
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