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[特发性肺纤维化和间质性肺异常的诊断进展]

[Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality].

作者信息

Nam Bo Da, Hwang Jung Hwa

出版信息

Taehan Yongsang Uihakhoe Chi. 2021 Jul;82(4):770-790. doi: 10.3348/jksr.2021.0072. Epub 2021 Jul 26.

Abstract

Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

摘要

根据2018年国际临床实践指南,特发性肺纤维化(IPF)可通过高分辨率计算机断层扫描(HRCT)上的普通间质性肺炎(UIP)模式以及相符的临床发现进行诊断。鉴于影像学对IPF评估和诊断至关重要,应更加重视整合临床、放射学和病理学发现以进行多学科诊断。另一方面,间质性肺异常(ILA)基于CT异常的偶然发现具有纯粹的放射学定义。综上所述,ILA与具有临床意义的间质性肺疾病(ILD)之间的鉴别必须基于恰当的临床评估。通过本综述,可以很好地理解IPF诊断的最新进展以及ILA的放射学考量,这有助于对弥漫性间质性肺纤维化患者进行恰当的诊断和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7679/9514410/dc47f28d38b1/jksr-82-770-g001.jpg

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