High-resolution CT (HRCT) is invaluable in the diagnosis and management of patients with diffuse lung disease, providing anatomic detail comparable with gross pathology. Although HRCT has proved most useful in the diagnosis of diffuse infiltrative lung diseases, its application to the diagnosis of airway and obstructive lung diseases has recently been emphasized.68 Müller N.L., Miller R.R. Diseases of the bronchioles: CT and histopathologic findings Radiology 1995 ; 196 : 3
Cliquez ici pour aller à la section Références, 102 Webb W.R. High-resolution computed tomography of obstructive lung disease Radiol Clin North Am 1994 ; 32 : 745
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Expiratory HRCT techniques as an adjunct to inspiratory are particularly useful in assessing patients with obstructive lung diseases, providing physiologic information in regard to regional lung function. In patients with obstructive lung diseases, morphologic abnormalities visible on inspiratory scans can be subtle or nonspecific in some patients. CT or HRCT obtained during forced exhalation (dynamic expiratory CT),93 Stern E.J., Webb W.R., Gamsu G. Dynamic quantitative computed tomography: A predictor of pulmonary function in obstructive lung diseases Invest Radiol 1994 ; 29 : 564 [cross-ref]
Cliquez ici pour aller à la section Références, 103 Webb W.R., Stern E.J., Kanth N. , et al. Dynamic pulmonary CT: Findings in normal adult men Radiology 1993 ; 186 : 117
Cliquez ici pour aller à la section Références during suspended respiration after forced exhalation (postexpiratory CT), or at a user-selected respiratory level controlled during exhalation using a spirometer (spirometrically triggered expiratory CT)41 Kalender W.A., Fichte H., Bautz W. , et al. Semiautomatic evaluation procedures for quantitative CT of the lung J Comput Assist Tomogr 1991 ; 15 : 248 [cross-ref]
Cliquez ici pour aller à la section Références, 42 Kalender W.A., Rienmuller R., Seissler W. , et al. Measurement of pulmonary parenchymal attenuation: Use of spirometric gating with quantitative CT Radiology 1990 ; 175 : 265
Cliquez ici pour aller à la section Références, 49 Lamers R.J., Thelissen G.R., Kessels A.G. , et al. Chronic obstructive pulmonary diseases: Evaluation with spirometrically controlled CT lung densitometry Radiology 1994 ; 193 : 109
Cliquez ici pour aller à la section Références have all been shown to be useful in the diagnosis of diseases characterized by airflow limitation or air-trapping. Focal, multifocal, or diffuse air-trapping visible using these expiratory or postexpiratory CT techniques as areas of abnormally low attenuation can confirm the presence of obstructive physiology in patients with airway abnormalities visible on inspiratory scans, allow the diagnosis of obstructive abnormalities in some patients with normal inspiratory scans, and help in distinguishing between obstructive disease and infiltrative disease as a cause of inhomogeneous lung opacity seen on inspiratory scans. Air-trapping on expiratory CT has been recognized in patients with various obstructive or airway diseases, such as emphysema,44 Kitahara Y., Takamoto M., Maruyama M. , et al. Differential diagnosis of pulmonary emphysema using the CT index: LL% [in Japanese] Nippon Kyobu Shikkan Gakkai Zasshi 1989 ; 27 : 689
Cliquez ici pour aller à la section Références, 46 Knudson R.J., Standen J.R., Kaltenborn W.T. , et al. Expiratory computed tomography for assessment of suspected pulmonary emphysema Chest 1991 ; 99 : 1357 [cross-ref]
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Cliquez ici pour aller à la section Références asthma,74 Newman K.B., Lynch D.A., Newman L.S. , et al. Quantitative computed tomography detects air trapping due to asthma Chest 1994 ; 106 : 105 [cross-ref]
Cliquez ici pour aller à la section Références constrictive bronchiolitis (CB),6 Aquino S.L., Webb W.R., Golden J. Bronchiolitis obliterans associated with rheumatoid arthritis: Findings on HRCT and dynamic expiratory CT J Comput Assist Tomogr 1994 ; 18 : 555 [cross-ref]
Cliquez ici pour aller à la section Références, 26 Garg K., Newell J.D. , et al. Proliferative and constrictive bronchiolitis: Classification and radiologic features AJR Am J Roentgenol 1994 ; 162 : 803
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Cliquez ici pour aller à la section Références, 76 Padley S.P.G., Adler B.D., Hansell D.M. , et al. Bronchiolitis obliterans: High-resolution CT findings and correlation with pulmonary function tests Clin Radiol 1993 ; 47 : 236 [cross-ref]
Cliquez ici pour aller à la section Références, 93 Stern E.J., Webb W.R., Gamsu G. Dynamic quantitative computed tomography: A predictor of pulmonary function in obstructive lung diseases Invest Radiol 1994 ; 29 : 564 [cross-ref]
Cliquez ici pour aller à la section Références, 97 Sweatman M.C., Millar A.B., Strickland B. , et al. Computed tomography in adult obliterative bronchiolitis Clin Radiol 1990 ; 41 : 116 [cross-ref]
Cliquez ici pour aller à la section Références and bronchiectasis.36 Hansell D.M., Wells A.U., Rubens M.B. , et al. Bronchiectasis: Functional significance of areas of decreased attenuation at expiratory CT Radiology 1994 ; 193 : 369
Cliquez ici pour aller à la section Références, 93 Stern E.J., Webb W.R., Gamsu G. Dynamic quantitative computed tomography: A predictor of pulmonary function in obstructive lung diseases Invest Radiol 1994 ; 29 : 564 [cross-ref]
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