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Connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonia: similarity and difference.

Semin Ultrasound CT MR. 2014 Feb;35(1):29-38

Authors: Bryson T, Sundaram B, Khanna D, Kazerooni EA

Abstract
Interstitial lung diseases (ILDs) are increasingly recognized in patients with systemic diseases. Patients with early ILD changes may be asymptomatic. Features of ILD overlap among systemic diseases and with idiopathic variety. High-resolution computed tomography plays a central role in diagnosing ILDs. Imaging features are often nonspecific. Therapy- and complication-related lung changes would pose difficulty in diagnosing and classifying an ILD. Biology and prognosis of secondary ILDs may differ between different disease-related ILDs and idiopathic variety. Combination of clinical features, serological tests, pulmonary and extrapulmonary imaging findings, and pathology findings may help to diagnose ILDs.

PMID: 24480141 [PubMed - in process]

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High-resolution computed tomography findings of acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis.

Semin Ultrasound CT MR. 2014 Feb;35(1):39-46

Authors: Ichikado K

Abstract
Diffuse alveolar damage (DAD) is the pathologic feature of rapidly progressive lung diseases, including acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis. The clinical significance and limitation of high-resolution computed tomography (HRCT) findings in these diseases were reviewed. The HRCT findings correlate well with pathologic phases (exudative, proliferative, and fibrotic) of DAD, although it cannot detect early exudative phase. Traction bronchiolectasis or bronchiectasis within areas of increased attenuation on HRCT scan is a sign of progression from the exudative to the proliferative and fibrotic phase of DAD. Extensive abnormalities seen on HRCT scans, which are indicative of fibroproliferative changes, were independently predictive of poor prognosis in patients with clinically early acute respiratory distress syndrome, acute interstitial pneumonia, and acute exacerbation of idiopathic pulmonary fibrosis.

PMID: 24480142 [PubMed - in process]

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High-resolution computed tomography features of smoking-related interstitial lung disease.

Semin Ultrasound CT MR. 2014 Feb;35(1):59-71

Authors: Nair A, Hansell DM

Abstract
The smoking-related interstitial lung diseases (ILDs) comprise several diseases that often coexist. In this review, the high-resolution computed tomography (CT) features and pathologic correlates of the traditional smoking-related ILDs (respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, and pulmonary Langerhans cell histiocytosis) and those ILDs with less clearly defined relationships to smoking are described. The degree to which these entities coexist and overlap is explored on high-resolution CT scans. Emerging evidence about the link between smoking and lung fibrosis (from lung cancer-screening trials with CT), and smoking as a factor in ageing of the lung, is also discussed.

PMID: 24480144 [PubMed - in process]

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Assessing the variability in respiratory acoustic thoracic imaging (RATHI).

Comput Biol Med. 2014 Feb;45:58-66

Authors: Charleston-Villalobos S, Torres-Jiménez A, González-Camarena R, Chi-Lem G, Aljama-Corrales T

Abstract
Multichannel analysis of lung sounds (LSs) has enabled the generation of a functional image for the temporal and spatial study of LS intensities in healthy and diseased subjects; this method is known as respiratory acoustic thoracic imaging (RATHI). This acoustic imaging technique has been applied to diverse pulmonary conditions, but it is important to contribute to the understanding of RATHI characteristics, such as acoustic spatial distribution, dependence on airflow and variability. The purpose of the current study is to assess the intra-subject and inter-subject RATHI variabilities in a cohort of 12 healthy male subjects (24.3±1.5 years) using diverse quantitative indices. The indices were obtained directly from the acoustic image and did not require scores from human raters, which helps to prevent inter-observer variability. To generate the acoustic image, LSs were acquired at 25 positions on the posterior thoracic surface by means of airborne sound sensors with a wide frequency band from 75up to 1000Hz under controlled airflow conditions at 1.0, 1.5 and 2.0L/s. To assess intra-subject variability, the degree of similitude between inspiratory acoustic images was evaluated through quadratic mutual information based on the Cauchy-Schwartz inequality (ICS). The inter-subject variability was assessed by an image registration procedure between RATHIs and X-ray images to allow the computation of average and variance acoustic image in the same coordinate space. The results indicated that intra-subject RATHI similitude, reflected by ICS-global, averaged 0.960±0.008, 0.958±0.008 and 0.960±0.007 for airflows of 1.0, 1.5, and 2L/s, respectively. As for the inter-subject variability, the variance image values for three airflow conditions indicated low image variability as they ranged from 0.01 to 0.04. In conclusion, the assessment of intra-subject and inter-subject variability by similitude indices indicated that the acoustic image pattern is repeatable along different respiratory cycles and across different subjects. Therefore, RATHI could be used to explore different aspects of spatial distribution and its association with regional pulmonary ventilation.

PMID: 24480164 [PubMed - in process]