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
Haga clic aquí para ir a la sección de Referencias, 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]
Haga clic aquí para ir a la sección de Referencias, 103 Webb W.R., Stern E.J., Kanth N. , y al. Dynamic pulmonary CT: Findings in normal adult men Radiology 1993 ; 186 : 117
Haga clic aquí para ir a la sección de Referencias 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. , y al. Semiautomatic evaluation procedures for quantitative CT of the lung J Comput Assist Tomogr 1991 ; 15 : 248 [cross-ref]
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Haga clic aquí para ir a la sección de Referencias 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. , y al. Differential diagnosis of pulmonary emphysema using the CT index: LL% [in Japanese] Nippon Kyobu Shikkan Gakkai Zasshi 1989 ; 27 : 689
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Haga clic aquí para ir a la sección de Referencias 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]
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Haga clic aquí para ir a la sección de Referencias and bronchiectasis.36 Hansell D.M., Wells A.U., Rubens M.B. , y al. Bronchiectasis: Functional significance of areas of decreased attenuation at expiratory CT Radiology 1994 ; 193 : 369
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© 1998
W. B. Saunders Company. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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