Tuberc Respir Dis.  1996 Jun;43(3):388-402. 10.4046/trd.1996.43.3.388.

Diffuse Infiltrative Lung Disease: Comparison of Diagnostic Accuracies of High-Resolution CT and Radiography

• Kim KA
• Kang EY
• Oh YW
• Kim JS
• Park JS
• Lee KS
• Kang KH
• Chung KB

• KMID: 2043519
• DOI: http://doi.org/10.4046/trd.1996.43.3.388

Abstract

BACKGROUND
To compare the diagnostic accuracies of High-resolution CT(HRCT) and chest radiography in the diagnosis of diffuse infiltrative lung disease(DILD).
METHODS
This study included ninety-nine patients with a diagnosis of acute or chronic DILD, representing 20 different diseases. Twelve normal subjects were included as control. The disease state was confirmed either pathologically or clinically. Radiographs and CT scans were evaluated separately by three independent observers without knowledge of clinical and pathologic results. The observers listed three most likely diagnoses and recorded degree of confidence.
RESULTS
The sensitivity of HRCT in the detection of DILD was 98.9% compared to 97.9% of chest radiography. Overall, a correct first-choice diagnosis was made in 48% using chest radiographs and in 60% using HRCT images. The correct diagnosis was among the top-three choices in 64% when chest radiographs were used, and in 75% when HRCT images were reviewed. Overally a confident diagnosis was reached more often with HRCT(55%) than with chest radiography(26%). The correct first-choice diagnosis increased remarkably when the HRCT was used in usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis and lymphangitic carcinomatosis.
CONCLUSION
HRCT is confirmed to be superior to conventional radiography in the detection and accurate diagnosis of DILD. HRCT is especially valuable in the diagnosis of usual interstitial pneumonia, miliary tuberculosis, diffuse panbronchiolitis, and lymphangitic carcinomatosis.

Keyword

Diffuse Infiltrative Lung Disease; Chest Radiography; High-Resolution CT

MeSH Terms

Carcinoma
Diagnosis
Humans
Idiopathic Pulmonary Fibrosis
Lung Diseases*
Lung*
Radiography*
Radiography, Thoracic
Thorax
Tomography, X-Ray Computed
Tuberculosis, Miliary