Mosaic Attenuation Pattern : A Guide to Analysis with HRCT - 04/10/22

Doi : 10.1016/j.rcl.2022.06.009

Gregory M. Lee, MD ^a, Melissa B. Carroll, MD ^b, Jeffrey R. Galvin, MD ^a, Christopher M. Walker, MD ^b,^⁎
^a Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, 22 South Greene Street, Baltimore, MD 21201, USA
^b Department of Radiology, University of Kansas Medical Center, 3901 Rainbow Blvd Kansas City, KS 66160, USA

^∗Corresponding author.

Résumé

Mosaic attenuation pattern is commonly encountered on high-resolution computed tomography and has myriad causes. These diseases may involve small airways, vessels, alveoli, or interstitium, with some involving compartmental combinations. Small airways disease is caused by cellular bronchiolitis, infiltrated by inflammatory cells or constrictive bronchiolitis, resulting in fibrosis of the small airways. Any acute or chronic cause of ground-glass opacity can result in a mosaic pattern. Vascular causes of mosaic attenuation include chronic thromboembolic pulmonary hypertension and rarely other causes of pulmonary arterial hypertension. Ancillary CT findings along with the clinical history help narrow the differential diangosis. Biopsy is uncommonly required for definitiive diagnosis.

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Keywords : Mosaic attenuation, Small airways disease, Constrictive bronchiolitis, Air trapping, High-resolution computed tomography, Expiratory phase