Lynch David A
Department of Radiology, University of Colorado Health Sciences Center, School of Medicine, Denver, Colorado 80262, USA.
Semin Respir Crit Care Med. 2003 Aug;24(4):365-76. doi: 10.1055/s-2003-42373.
The fibrotic idiopathic interstitial pneumonias comprise usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). The characteristic high-resolution computed tomography findings of UIP are reticular abnormality and honeycombing with basal and peripheral predominance. Honeycombing is the strongest predictor of UIP. The extent of fibrosis on computed tomography (CT) is an important prognostic indicator in idiopathic pulmonary fibrosis (IPF). When ground-glass attenuation is seen in IPF it commonly progresses to fibrosis and honeycombing. Imaging may help to detect complications of IPF, including accelerated progression, lung cancer, and secondary infection. Our understanding of the clinical and radiological features of NSIP is still evolving. The CT finding of extensive ground-glass abnormality and some reticular abnormality, with basal and peripheral predominance, is strongly suggestive of NSIP. However, the CT appearances of NSIP overlap with those of UIP, organizing pneumonia (OP), and desquamative interstitial pneumonia (DIP), and biopsy may be necessary to sort this out. Other idiopathic pneumonias that may be associated with CT evidence of lung fibrosis include DIP, OP, acute interstitial pneumonia, and lymphoid interstitial pneumonia.
纤维化型特发性间质性肺炎包括寻常型间质性肺炎（UIP）和非特异性间质性肺炎（NSIP）。UIP的高分辨率计算机断层扫描特征性表现为网状异常和蜂窝状改变，以下肺和外周为主。蜂窝状改变是UIP最强的预测指标。计算机断层扫描（CT）上的纤维化程度是特发性肺纤维化（IPF）的重要预后指标。IPF出现磨玻璃样密度影时通常会进展为纤维化和蜂窝状改变。影像学检查有助于发现IPF的并发症，包括病情加速进展、肺癌和继发感染。我们对NSIP临床和影像学特征的认识仍在不断发展。CT表现为广泛的磨玻璃样异常和一些网状异常，以下肺和外周为主，强烈提示为NSIP。然而，NSIP的CT表现与UIP、机化性肺炎（OP）和脱屑性间质性肺炎（DIP）有重叠，可能需要进行活检来明确。其他可能伴有肺纤维化CT证据的特发性肺炎包括DIP、OP、急性间质性肺炎和淋巴细胞间质性肺炎。
