a Université Paris 13, EA2363 "Hypoxie & Poumon" , Sorbonne-Paris-Cité , Bobigny, France.
b Service de pneumologie , hôpital Avicenne , Bobigny , France.
Expert Rev Respir Med. 2019 Jan;13(1):79-94. doi: 10.1080/17476348.2019.1556639. Epub 2018 Dec 12.
High-resolution computed tomography (HRCT) has revolutionized the diagnosis, prognosis and in some cases the prediction of therapeutic response in interstitial lung disease (ILD). HRCT represents an essential second step to a patient's clinical history, before considering any other investigation, including lung biopsy. Areas covered: This review describes the current place of HRCT in the diagnosis, prognosis and monitoring of ILD. It also lists some perspectives for the near future. Expert commentary: Since the 1980s, HRCT and its interpretation have improved, the diagnosis value of patterns, and the integration of bio-clinical elements to HRCT have been better standardized. The interobserver agreement has been investigated, allowing a better use of some limits in the interpretation of various signs. It not only takes into account one particular predominant sign, but the combination of patterns and the distribution of findings. Thanks to HRCT, the range of diagnoses and their probability are more accurately identified. The contribution of HRCT has been optimized during the multidisciplinary discussion that a difficult diagnosis calls for. HRCT quantification of the extent of diffuse lung disease becomes possible and is linked to prognosis. In the future, artificial intelligence may significantly modify the practice of radiology.
高分辨率计算机断层扫描（HRCT）改变了间质性肺疾病（ILD）的诊断、预后，在某些情况下还改变了治疗反应的预测。在考虑任何其他检查，包括肺活检之前，HRCT 是患者临床病史的重要的第二步。
这篇综述描述了 HRCT 在ILD 的诊断、预后和监测中的当前地位。它还列出了一些近期的展望。
自 20 世纪 80 年代以来，HRCT 及其解读、模式的诊断价值以及 HRCT 与生物临床要素的整合得到了更好的标准化。观察者间的一致性已经得到了研究，允许更好地使用各种征象解读中的一些限制。它不仅考虑到一个特定的主要征象，而且还考虑到了各种征象的组合和分布。得益于 HRCT，可以更准确地识别诊断范围和其概率。在需要多学科讨论的困难诊断中，HRCT 的作用得到了优化。弥漫性肺疾病程度的 HRCT 定量成为可能，并与预后相关。未来，人工智能可能会极大地改变放射学的实践。
