Chest
Clinical Investigations: Diffuse Lung DiseaseThe Diagnostic Accuracy of High-Resolution Computed Tomography in Diffuse Infiltrative Lung Diseases
Section snippets
Patients
A total of 134 patients with DILD were examined. The study encompassed 21 different pulmonary diseases, and included 82 male and 52 female patients with a mean age of 49.1 years (range, 19 to 84 years). A specific diagnosis for each patient was confirmed histologically or microbiologically. Both chest radiographs and HRCT were obtained between 1982 and 1990 at the Chest Disease Research Institute, Kyoto University. The mean time interval between chest radiography and CT scanning was 12.1 days.
Results
Overall, a correct first-choice diagnosis was made in 38 percent using chest radiography and in 46 percent using HRCT (p<0.01). The correct diagnosis was among the top three choices in 49 percent using chest radiographs and in 59 percent using HRCT images (p<0.01). Therefore, for the diagnosis of DILD, HRCT is significantly superior to chest radiography.
The percentages for correct first diagnoses for each disease are listed in Table 2. Compared with chest radiography, the use of HRCT increased
Discussion
The present study confirmed the usefulness of HRCT in clinical practice. When the diagnosis is not known at the time the patient is referred for a CT scan, the study showed that HRCT can enhance the diagnostic accuracy for DILD, because the overall correct first-choice diagnosis, correct diagnosis among the top three choices, and the positive predictive values of first-choice diagnoses were significantly improved by HRCT compared with chest radiography.
Some biases and problems were inherent in
Acknowledgments
The authors are grateful to the following for participating in the conference: Yasuyuki Kurihara, M.D. (Department of Radiology, St. Mariannu University of Medical Science); Humikazu Sakai, M.D. (Department of Radiology, Sinsyu University Medical School); Giro Todo, M.D. (Nagahama Red Cross Hospital); Kiyoshi Murata, M.D. (Department of Radiology, Shiga University of Medical Science); Masayuki Hatakeyama, M.D. (Mimuro Hospital); Shizuo Morimoto, M.D., and Tuyoshi Jiyoukou, M.D. (Department of
References (34)
- et al.
Comparative accuracy of high resolution computed tomography and chest radiography in the diagnosis of chronic diffuse infiltrative lung disease
Clinical Radiology
(1991) - et al.
Bronchiolitis obliterans organizing pneumonia: clinical features and differential diagnosis
Chest
(1992) - et al.
Diffuse panbronchiolitis: a disease of the transitional zone of the lung
Chest
(1983) A new look at pattern recognition of diffuse pulmonary disease
AJR
(1979)- et al.
Diffuse infiltrative lung disease: a new scheme for description
Radiology
(1983) - et al.
Computed tomography of the pulmonary parenchyma: II. Interstitial disease
J Thorac Imag
(1985) - et al.
Recent progress of chest imaging
- et al.
State of the art: computed tomography of chronic diffuse infiltrative lung disease: I
Am Rev Respir Dis
(1990) - et al.
State of the art: computed tomography of chronic diffuse infiltrative lung disease: II
Am Rev Respir Dis
(1990) - et al.
The role of high-resolution computed tomography in the diagnosis of interstitial lung disease
Thorax
(1991)