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Comparative manifestations and diagnostic accuracy of high-resolution computed tomography in usual interstitial pneumonia and nonspecific interstitial pneumonia.
Curr Opin Pulm Med. 2012 Sep; 18(5):530-4.CO

Abstract

PURPOSE OF REVIEW

Of the idiopathic interstitial pneumonias, the differentiation between idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonitis (NSIP) raises considerable diagnostic challenges, as their clinical presentations share many overlapping features. IPF is a fibrosing pneumonia of unknown cause, showing a histologic pattern of usual interstitial pneumonia (UIP), and has a poorer prognosis than does NSIP. This review examines whether the radiographic features of IFP and NSIP as assessed by high-resolution computed tomography (HRCT) can be used to distinguish between these two entities.

RECENT FINDINGS

The diagnostic accuracy of HRCT for UIP and NSIP has been reported to be approximately 70% in various studies. Disagreement between the HRCT diagnosis and the histologic diagnosis occurs in approximately one-third of the cases. The predominant feature of honeycombing on HRCT yields a specificity of approximately 95% and sensitivity of approximately 40% for UIP. In contrast, a predominant feature of ground glass opacities (GGOs) gives a sensitivity of approximately 95% and specificity of approximately 40% for NSIP.

SUMMARY

The finding of honeycombing as the predominant HRCT feature suggests the diagnosis of UIP and may exclude the need for biopsy. Predominant features of GGOs are not specific enough to distinguish between NSIP and UIP.

Authors+Show Affiliations

Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. minksn@cc.umanitoba.caNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

22759772

Citation

Mink, Steven N., and Bruce Maycher. "Comparative Manifestations and Diagnostic Accuracy of High-resolution Computed Tomography in Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia." Current Opinion in Pulmonary Medicine, vol. 18, no. 5, 2012, pp. 530-4.
Mink SN, Maycher B. Comparative manifestations and diagnostic accuracy of high-resolution computed tomography in usual interstitial pneumonia and nonspecific interstitial pneumonia. Curr Opin Pulm Med. 2012;18(5):530-4.
Mink, S. N., & Maycher, B. (2012). Comparative manifestations and diagnostic accuracy of high-resolution computed tomography in usual interstitial pneumonia and nonspecific interstitial pneumonia. Current Opinion in Pulmonary Medicine, 18(5), 530-4. https://doi.org/10.1097/MCP.0b013e3283568026
Mink SN, Maycher B. Comparative Manifestations and Diagnostic Accuracy of High-resolution Computed Tomography in Usual Interstitial Pneumonia and Nonspecific Interstitial Pneumonia. Curr Opin Pulm Med. 2012;18(5):530-4. PubMed PMID: 22759772.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative manifestations and diagnostic accuracy of high-resolution computed tomography in usual interstitial pneumonia and nonspecific interstitial pneumonia. AU - Mink,Steven N, AU - Maycher,Bruce, PY - 2012/7/5/entrez PY - 2012/7/5/pubmed PY - 2012/12/19/medline SP - 530 EP - 4 JF - Current opinion in pulmonary medicine JO - Curr Opin Pulm Med VL - 18 IS - 5 N2 - PURPOSE OF REVIEW: Of the idiopathic interstitial pneumonias, the differentiation between idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonitis (NSIP) raises considerable diagnostic challenges, as their clinical presentations share many overlapping features. IPF is a fibrosing pneumonia of unknown cause, showing a histologic pattern of usual interstitial pneumonia (UIP), and has a poorer prognosis than does NSIP. This review examines whether the radiographic features of IFP and NSIP as assessed by high-resolution computed tomography (HRCT) can be used to distinguish between these two entities. RECENT FINDINGS: The diagnostic accuracy of HRCT for UIP and NSIP has been reported to be approximately 70% in various studies. Disagreement between the HRCT diagnosis and the histologic diagnosis occurs in approximately one-third of the cases. The predominant feature of honeycombing on HRCT yields a specificity of approximately 95% and sensitivity of approximately 40% for UIP. In contrast, a predominant feature of ground glass opacities (GGOs) gives a sensitivity of approximately 95% and specificity of approximately 40% for NSIP. SUMMARY: The finding of honeycombing as the predominant HRCT feature suggests the diagnosis of UIP and may exclude the need for biopsy. Predominant features of GGOs are not specific enough to distinguish between NSIP and UIP. SN - 1531-6971 UR - https://www.unboundmedicine.com/medline/citation/22759772/Comparative_manifestations_and_diagnostic_accuracy_of_high_resolution_computed_tomography_in_usual_interstitial_pneumonia_and_nonspecific_interstitial_pneumonia_ L2 - http://dx.doi.org/10.1097/MCP.0b013e3283568026 DB - PRIME DP - Unbound Medicine ER -