Inhomogeneous lung attenuation at thin-section CT: diagnostic value of expiratory scans

Radiology
Hiroaki ArakawaR F Seitz

Abstract

To determine the utility of expiratory scans for diagnosis of inhomogeneous attenuation on thin-section computed tomographic (CT) scans. On the basis of clinical information and pulmonary function test results, disease in 53 patients with inhomogeneous attenuation on inspiratory scans was classified into four groups--infiltrative, airway, vascular, or mixed. Without knowledge of the diagnosis, inhomogeneous attenuation was classified as (a) ground-glass opacity due to infiltrative disease, (b) mosaic perfusion due to airway disease, or (c) mosaic perfusion due to vascular disease, and the degree of confidence was indicated. Each case was reclassified if necessary on the basis of expiratory scan findings. A correct diagnosis was made more often on the basis of both inspiratory and expiratory scans than on the basis of inspiratory scans alone (92% [49 of 53 patients] vs 79% [42 of 53], respectively [P < .05]). Accuracy increased from 81% (21 of 26) to 89% (23 of 26) in cases of infiltrative disease and from 84% (16 of 19) to 100% (19 of 19) in cases of airway disease. A correct interpretation with high confidence level was reached more often with expiratory scans than on the basis of inspiratory scans alone (92% [49 of 53] vs 45%...Continue Reading

Citations

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