Chest
Chest Imaging for CliniciansPictorial Essay: Multinodular Disease
Section snippets
Algorithm Overview
Due to its ability to evaluate the lung parenchyma in cross-section, eliminating the superimposition of densities, CT scanning offers a unique opportunity to evaluate lung nodules in exquisite detail.2 This includes first the ability to assess lesions by anatomic distribution, and second by morphology.3, 4, 5
Multinodular HRCT Algorithm: A Step-Wise Approach
The use of this algorithm begins by dividing CT scans into two broad arms based on the presence (group 1) or absence (group 2) of pleural or perifissural involvement (Table 1).
Conclusion
The finding of multiple lung nodules is a characteristic that encompasses a number of disparate parenchymal diseases. Although inexact, the use of anatomic and morphologic features to characterize nodules based on HRCT scan findings may help to simplify the differential diagnosis. Most importantly, the use of this imaging algorithm can prove to be an aid in standardizing the clinical approach to differential diagnosis. In a study reported by Gruden et al,4 four experienced chest radiologists
References (51)
Imaging of metastatic disease to the thorax
Radiol Clin North Am
(2005)- et al.
Significance of percutaneous needle biopsy in patients with multiple pulmonary nodules and a single known primary malignancy
Chest
(1995) Hypersensitivity pneumonitis: a multifaceted deceiving disorder
Clin Chest Med
(2004)- et al.
Respiratory bronchiolitis-associated interstitial lung disease and its relationship to desquamative interstitial pneumonia
Mayo Clin Proc
(1989) - Webb, WR, Muller, NL, Naidich, DP, 2001. Lippincott, Williams and Wilkins Philadelphia, PA 3rd...
- et al.
Anatomic distribution and histopathologic patterns in diffuse lung disease: correlation with HRCT
J Thorac Imaging
(1996) - et al.
Secondary pulmonary lobule: normal and abnormal CT appearance
AJR Am J Roentgenol
(1988) - et al.
Centrilobular opacities on HRCT: diagnosis and differential diagnosis with pathologic correlation
AJR Am J Roentgenol
(1994) - et al.
Centrilobular lesions of the lung: demonstration by high resolution CT and pathologic correlation
Radiology
(1986) - et al.
The CT findings of pulmonary sarcoidosis: analysis of 25 patients
AJR Am J Roentgenol
(1989)
Adult onset of pulmonary tuberculosis: findings on chest radiographs and CT scans
AJR Am J Roentgenol
Appearance of pulmonary metastases on high-resolution CT scans: comparison with histopathologic findings from autopsy specimens
AJR Am J Roentgenol
Tree-in-bud pattern: frequency and significance on thin-section CT
J Comput Assist Tomogr
Pulmonary histiocytosis X: comparison of radiographic and CT findings
Radiology
Pulmonary nodules: preliminary experience with three-dimensional evaluation
Radiology
Design and structure of the human lung
Pulmonary sarcoidosis: evaluation with high-resolution CT
Radiology
Pulmonary sarcoidosis: correlation of CT and histopathologic findings
Radiology
Computed tomographic evaluation of silicosis and coal worker’s pneumoconiosis
Radiol Clin North Am
Silicosis in 76 men: qualitative and quantitative CT evaluation- clinical-radiologic correlation study
Radiology
Imaging of occupational lung disease
Radiographics
CT findings in lymphangitic carcinomatosis of the lung: correlation with histologic findings and pulmonary function tests
AJR Am J Roentgenol
Appearance of pulmonary metastases on high-resolution CT scans: comparison with histopathologic findings from autopsy specimens
AJR Am J Roentgenol
Blood supply of pulmonary metastases
J Thorac Imaging
Computed tomography halo sign of pulmonary nodules: frequency and diagnostic value
J Thorac Imaging
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