Learn the relevant CT patterns and findings for the evaluation of suspected usual interstitial pneumonia
Systematize diagnostic criteria from the Fleischner Society white paper that allows uniformed classification of idiopathic pulmonary fibrosis
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic,
progressive fibrosing interstitial pneumonia of unknown cause.
The histopathological and radiological patterns of usual interstitial pneumonia (UIP) are associated with IPF.
Many diseases can produce fibrosing interstitial lung disease (ILD).
In order to make the diagnosis of IPF,
alternative causes of fibrosing ILD must be excluded.
It is important to look for connective tissue diseases,
exposure to antigens that might result in hypersensitivity pneumonitis and drug toxicity,
since other diseases may present with radiological UIP...
Findings and procedure details
Cases of suspected IPF of the author’s clinical practice were collected.
The HRCT examinations were reviewed to look for the different radiological features of IPF according to the diagnostic criteria of the Fleischner Society.
Examples of the different HRCT patterns and findings are presented.
HRCT features frequently seen in UIP include honeycombing,
traction bronchiectasis and bronchiolectasis.
A fine reticular pattern and,
ground-glass opacification in the context of fibrosis may be present as well.
Honeycombing is a key characteristic of the UIP pattern.
Diagnosis of IPF is,
radiologists and pathologists.
The new diagnostic criteria from the Fleischner Society white paper,
along with the clinical guidelines from ATS/ERS/JRS/ALAT provide a common and less ambiguous lexicon for IPF among physicians,
promoting better clinical communication and management of patients.
Since radiological imaging plays a crucial role in diagnosis of IPF,
it is of utmost importance for the radiologist to be comfortable with these diagnosticcriteria.
Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper.
Lancet Respir Med 2017; published online November 17.
Diagnosis of idiopathic pulmonary fibrosis.
An official ATS/ERS/JRS/ ALAT clinical practice guideline.
Am J Respir Crit Care Med 2018; 198: e44–e68
Fleischner Society: Glossary of Terms for Thoracic Imaging.
Radiology 2008; 246(3): 697-722