CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL - PowerPoint PPT Presentation

Loading...

PPT – CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL PowerPoint presentation | free to download - id: 3ce163-N2E3M



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL

Description:

CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL OPACIFICATION etin Atasoy, M.D. Ankara University Medical School BOOP Mucinous BAC BAC Thank you for your attention ... – PowerPoint PPT presentation

Number of Views:56
Avg rating:3.0/5.0
Slides: 76
Provided by: fileTora
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL


1
CT DIFFERENTIAL DIAGNOSIS OF DIFFUSE PARENCHYMAL
OPACIFICATION
  • Çetin Atasoy, M.D.
  • Ankara University Medical School

2
  • Ground glass density Subtle density increase
    without vascular obscuration
  • Consolidation Denser opacification that
    obliterates underlying vessels

3
(No Transcript)
4
(No Transcript)
5
(No Transcript)
6
Ground glass
  • Purely interstitial disease
  • Both interstitial and alveolar disease
  • Purely alveoler diseases

7
Ground glass / Etiology
  • With acute symptomatology
  • Acute interstitial pneumonitis
  • ARDS
  • Hydrostatic edema
  • Alveoler hemorrhage
  • Pneumonias (PCP, viral)
  • Acute eosinophilic pneumonia

8
With subacute / chronic symptoms
  • Idiopathic interstitial pneumonias (IPF, NSIP,
    DIP, respiratory bronchiolitis, BOOP)
  • Hypersensitivity pneumonitis
  • Chronis eosinophilic pneumonia
  • Lipoid pneumonia
  • Bronchioloalveolar cancer
  • Sarcoidosis
  • Alveolar proteinosis

9
CT differential diagnosis
  • Lesion distribution
  • Centrilobular?
  • Patchy and/or peripheral?
  • Diffuse?
  • Any reticular pattern present?
  • Interlobular septal thickening?
  • Intralobular interstitial thickening?

10
Centrilobular ground glass nodules
  • Hypersensitivity pneumonia
  • Respiratory bronchiolitis
  • Edema
  • Vasculitis
  • CMV pneumonia
  • Pneumocystis pneumonia
  • BOOP
  • Lymphocytic interstitial pneumonia

11
Respiratory bronchiolitis
12
Respiratory bronchiolitis
  • 3-5 mm diameter centrilobular nodules
  • Diffuse ground glass areas
  • Predominant involvement upper lobes
  • Emphysema
  • RB-ILD Honeycombing, intralobular opacities

13
(No Transcript)
14
Emphysema
15
Hypersensitivity pneumonitis
16
Hypersensitivity pneumonitis
  • Diffuse ground glass density and / or
    consolidations
  • Centrilobular micronodules
  • Mosaic perfusion and air trapping

17
(No Transcript)
18
Edema
19
(No Transcript)
20
Diffuse ground glass areas
  • Hypersensivity pneumonitis
  • Edema
  • Hemorrhage
  • Pneumonias (PCP, viral)
  • ARDS
  • Acute interstitial pneumonitis

21
Hypersensitivity pneumonitis
22
Edema
23
Hydrostatic edema
  • Ground glass areas / nodules
  • Septal thickening (smooth)
  • Fissural thickening (smooth)
  • Predominant involvement
  • Perihilar
  • Posterior
  • Other findings
  • Cardiomegaly
  • Pleural effusion
  • Bronchial cuffing

24
Central involvement
Posterior areas
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
9 month old, HIV
Brit J Radiol
Pneumocystis pneumonia
33-year-old male, HIV
29
Pneumocystis pneumonia
  • Immunosuppression (particularly AIDS)
  • Patchy or diffuse ground glass areas or
    consolidations
  • Predominant involvement Central parts of upper
    lobes
  • Cavities or cysts
  • Nodules
  • Enlarged mediastinal lymph nodes
  • Pleural effusion
  • Recovery phase reticulation

30
Cysts
Upper zone involvement
31
(No Transcript)
32
Diffuse pulmonary hemorrhage
  • Hemoptysis, anemia
  • Diffuse ground glass areas or consolidations
  • Rapid resurgence and clearance
  • No cardiomegaly, no or minimal pleural effusion

33
Acute interstitial pneumonia
Radiographics
34
Acute interstitial pneumonia
  • Exudative phase
  • Diffuse ground glass or consolidation
  • (more prominent in lower zones and dependent
    regions)
  • Proliferative phase
  • Traction bronchiectasis, architectural
    distortion, honeycombing

35
Pathcy / peripheral distribution
  • Idiopathic interstial pneumonias (IPF, NSIP, DIP,
    BOOP)
  • Eosinophilic pneumonia
  • Alveolar proteinosis
  • Sarcoidosis
  • Edema
  • Hemorrhage

36
DIP
37
DIP
  • Ground glass areas basal and peripheral
  • Emphysema
  • Sometimes fibrosis
  • Irregular linear opacities
  • Honeycombing milder than in IPF

38
(No Transcript)
39
DIP
40
IPF
41
IPF
  • Predominant involvement
  • Lower zones, peripheral subpleural areas
  • Marked honeycombing
  • Bronchiectasis, distortion, volume loss
  • Thickening of intralobular interstitium

42
IPF
43
(No Transcript)
44
NSIP
45
NSIP
  • Patchy ground glass or consolidations
  • Peripheral parts of lower zones
  • Reticulation
  • Differentiation from IPF
  • Milder honeycombing
  • Relative subpleural sparing

46
(No Transcript)
47
Asbestosis
48
BOOP
49
BOOP
  • Subpleural / peribronchial multifocal
  • Consolidation and/or ground glass
  • Bronchial changes
  • Ancillary findings
  • Nodüles
  • Non-septal lines
  • Reverse halo sign
  • Perilobular pattern

50
BOOP following BMT
51
Reverse halo sign
52
Perilobular pattern
53
Crazy paving
  • Thick septa superposed on ground glass
  • Alveoler proteinosis
  • Pneumonias (PCP, bacterial, viral)
  • ARDS
  • AIP
  • Hemorrhage, edema
  • BOOP
  • Bronchioloalveolar cancer
  • Lipoid pneumonia

54
PAP
55
Pulmonary alveolar proteinosis
  • Geographic appearance
  • Thick septa only in ground glass areas
  • Sharp demarcation of diseases areas
  • Clinicoradiologic discrepancy

56
Geographic involvement
No central / peripheral dominance
57
PCP
Radiographics
BAC
Bleeding
58
Consolidation
  • Similar differential diagnosis as ground glass

59
Causes of consolidation
  • Pneumonias
  • BOOP
  • Esinophilic pneumonia
  • Hypersensitivity pneumonitis
  • BAC, lymphoma
  • PAP
  • AIP, ARDS
  • Sarcoidosis
  • Edema

60
PCP
PCP
61
AIP
62
31.1.2007
19.2.2007
BOOP
30.3.2007
63
10.2.2007
BOOP
5.4.2007
64
BOOP
65
BOOP
Subpleural / peribronchial
66
BOOP
67
(No Transcript)
68
Mucinous BAC
69
BAC
70
Thank you for your attention
71
52 year old male with pulmonary hypertension
72
Pulmonary venoocclusive disease
73
Metastatic pulmonary calcification
Chronic renal failure
74
Wegener
75
Alveolar microlithiasis
About PowerShow.com