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Stepwise diagnostic algorithm for high-attenuation pulmonary abnormalities on CT

delete2023-10-20
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T
Taiki Fukuda *
E
Egashira, Ryoko
M
Midori Ueno
M
Mikiko Hashisako
H
Hiromitsu Sumikawa
J
Junya Tominaga
D
Daisuke Yamada
J
Junya Fukuoka
S
Shigeki Misumi
H
Hiroya Ojiri
H
Hiroto Hatabu
T
Takeshi Johkoh
DOI:10.1186/s13244-023-01501-xdelete
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摘要

摘要

En 中文
High-attenuation pulmonary abnormalities are commonly seen on CT. These findings are increasingly encountered with the growing number of CT examinations and the wide availability of thin-slice images. The abnormalities include benign lesions, such as infectious granulomatous diseases and metabolic diseases, and malignant tumors, such as lung cancers and metastatic tumors. Due to the wide spectrum of diseases, the proper diagnosis of high-attenuation abnormalities can be challenging. The assessment of these abnormal findings requires scrutiny, and the treatment is imperative. Our proposed stepwise diagnostic algorithm consists of five steps. Step 1: Establish the presence or absence of metallic artifacts. Step 2: Identify associated nodular or mass-like soft tissue components. Step 3: Establish the presence of solitary or multiple lesions if identified in Step 2. Step 4: Ascertain the predominant distribution in the upper or lower lungs if not identified in Step 2. Step 5: Identify the morphological pattern, such as linear, consolidation, nodular, or micronodular if not identified in Step 4. These five steps to diagnosing high-attenuation abnormalities subdivide the lesions into nine categories. This stepwise radiologic diagnostic approach could help to narrow the differential diagnosis for various pulmonary high-attenuation abnormalities and to achieve a precise diagnosis.Critical relevance statement Our proposed stepwise diagnostic algorithm for high-attenuation pulmonary abnormalities may help to recognize a variety of those high-attenuation findings, to determine whether the associated diseases require further investigation, and to guide appropriate patient management.Key points center dot To provide a stepwise diagnostic approach to high-attenuation pulmonary abnormalities.center dot To familiarize radiologists with the varying cause of high-attenuation pulmonary abnormalities.center dot To recognize which high-attenuation abnormalities require scrutiny and prompt treatment.
Keyword:
Lung diseases
Tomography (X-ray computed)
Algorithms
High attenuation
Calcification
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