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

Kim, Kyeong Ah; Kang, Eun Young; Oh, Yu Whan; Kim, Jeung Sook; Park, Jai Soung; Lee, Kyung Soo; Kang, Kyung Ho; Chung, Kyoo Byung

doi:1996.43.3.388

Tuberc Respir Dis > Volume 43(3); 1996 > Article

Original Article

Tuberculosis and Respiratory Diseases 1996;43(3):388-402.
DOI: https://doi.org/10.4046/trd.1996.43.3.388 Published online June 1, 1996.

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

Kyeong Ah Kim, Eun Young Kang, Yu Whan Oh, Jeung Sook Kim, Jai Soung Park, Kyung Soo Lee, Kyung Ho Kang, Kyoo Byung Chung

¹Department of Diagnostic Radiology, College of Medicine, Korea University, Korea.
²Department of Diagnostic Radiology, Kyunghee-Pundang Cha General Hospital, Korea.
³Department of Diagnostic Radiology, College of Medicine, Soonchunhyang University, Korea.
⁴Department of Diagnostic Radiology, Samsung Medical Center, Korea.
⁵Department of Internal Medicine, College of Medicine, Korea University, Korea.

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.

Key Words: Diffuse Infiltrative Lung Disease, Chest Radiography, High-Resolution CT