Differentiation of pulmonary complications with extensive ground-glass attenuation on high-resolution CT in immunocompromised patients.

Abstract

PURPOSE:

The purpose of this study was to compare the high-resolution CT (HRCT) findings of pulmonary infectious and noninfectious complications with extensive ground-glass attenuation (GGA) in immunocompromised patients.

MATERIALS AND METHODS:

One hundred fifty-two immunocompromised patients with pulmonary complications that showed extensive GGA (> 50% of the whole lung on HRCT) were included in this study. The diagnoses of the 152 patients were as follows: pneumocystis pneumonia (PCP), n = 82; drug-induced pneumonia, n = 38; bacterial pneumonia, n = 9; cytomegalovirus pneumonia, n = 6; idiopathic pneumonia syndrome, n = 6; diffuse alveolar hemorrhage (DAH), n = 4; fungal infection, n = 3; tuberculosis, n = 2 and pulmonary edema, n = 2. Two chest radiologists retrospectively evaluated the CT criteria, which consisted of 12 findings.

RESULTS:

The nodule (p = 0.015), the bronchovascular bundle (BVB) thickening (p = 0.001), and the interlobular septum (ILS) thickening (p = 0.002) were significantly infrequent in PCP. The ILS thickening was significantly frequent in drug-induced pneumonia (p < 0.001) though it was also frequent in other noninfectious and infectious diseases. The BVB thickening was significantly frequent in bacterial pneumonia (p = 0.005). The nodule was significantly frequent in DAH (p = 0.049).

CONCLUSION:

Nodules, BVB thickening, and ILS thickening could be useful HRCT findings for the differential diagnosis of pulmonary complications in immunocompromised patients with extensive GGA.

• Authors: Yoshie Kunihiro, Nobuyuki Tanaka, Reo Kawano, Tsuneo Matsumoto, Taiga Kobayashi, Toshiaki Yujiri, Makoto Kubo, Toshikazu Gondo, Katsuyoshi Ito
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 39 Issue 9 Pg. 868-876 (Sep 2021) ISSN: 1867-108X [Electronic] Japan
• PMID: 33945100 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Topics

• Humans
• Immunocompromised Host
• Lung (diagnostic imaging)
• Lung Diseases (diagnostic imaging)
• Retrospective Studies
• Tomography, X-Ray Computed