HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Holbert, J. M. Articles by Rogers, R. M. Search for Related Content PubMed PubMed Citation Articles by Holbert, J. M. Articles by Rogers, R. M. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

CT Features of Pulmonary Alveolar Proteinosis

¹ Department of Radiology, University of Pittsburgh, St. Margaret, 815 Freeport Rd., Pittsburgh, PA 15215.
² Present address: Department of Radiology, Scott & White Memorial Hospital and Clinic, 2401 S. 31st St., Temple, TX 16508.
³ Department of Radiology, Brigham & Women's Hospital, 75 Francis St., Boston, MA 02215.
⁴ Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261.
⁵ Department of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Montefiore, G-Level, 3459 Fifth Ave., Pittsburgh, PA 15213.

OBJECTIVE. This investigation describes the CT features of pulmonary alveolar proteinosis in a large group of patients.

MATERIALS AND METHODS. A retrospective review of 139 chest CT scans (79 thick-section scans and 60 thin-section scans) from 27 patients with pathologically proven pulmonary alveolar proteinosis was performed. Two independent observers assessed the intraslice patterns and zonal distribution of disease on three CT images of each lung. The observers also graded the percentage of ground-glass opacities, air-space opacities, fibrosis, interlobular opacities, intralobular opacities, and emphysema in each slice. CT scans obtained before and after lavage related to 12 whole-lung lavage treatments on nine patients were evaluated.

RESULTS. The dominant intraslice pattern was geographic, but a diffuse pattern was sometimes seen. The most common zonal pattern was uniform; a lower zone predominance was next most frequent. Ground-glass, air-space, and fibrotic opacities had a generally homogeneous craniocaudal distribution, but there was a trend toward more interlobular opacities at the lung bases (p < 0.002). Ground-glass opacities were seen on at least one scan in 100% of the patients. Interlobular opacities (85%), air-space opacities (78%), substantial fibrosis (7%), and intralobular opacities (7%) occurred less frequently. Compared with thick-section images, thin-section images showed more interlobular opacities, but no difference in ground-glass, air-space, or fibrotic disease. The proportion of lung affected by ground-glass and interlobular opacities decreased significantly (p < 0.05) after lavage.

CONCLUSION. Pulmonary alveolar proteinosis does not present only with alveolar disease. The CT appearance typically combines different types of opacities with a geographic pattern and a uniform zonal distribution with variation over time.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				H. Ishii, B. C. Trapnell, R. Tazawa, Y. Inoue, M. Akira, Y. Kogure, K. Tomii, T. Takada, M. Hojo, T. Ichiwata, et al. Comparative Study of High-Resolution CT Findings Between Autoimmune and Secondary Pulmonary Alveolar Proteinosis Chest, November 1, 2009; 136(5): 1348 - 1355. [Abstract] [Full Text] [PDF]

				S. Vrielynck, T. Mamou-Mani, S. Emond, P. Scheinmann, F. Brunelle, and J. de Blic Diagnostic Value of High-Resolution CT in the Evaluation of Chronic Infiltrative Lung Disease in Children Am. J. Roentgenol., September 1, 2008; 191(3): 914 - 920. [Abstract] [Full Text] [PDF]

				A. A. Frazier, T. J. Franks, E. O. Cooke, T.-L. H. Mohammed, R. D. Pugatch, and J. R. Galvin From the Archives of the AFIP: Pulmonary Alveolar Proteinosis RadioGraphics, May 1, 2008; 28(3): 883 - 899. [Abstract] [Full Text] [PDF]

				Y. Inoue, B. C. Trapnell, R. Tazawa, T. Arai, T. Takada, N. Hizawa, Y. Kasahara, K. Tatsumi, M. Hojo, T. Ichiwata, et al. Characteristics of a Large Cohort of Patients with Autoimmune Pulmonary Alveolar Proteinosis in Japan Am. J. Respir. Crit. Care Med., April 1, 2008; 177(7): 752 - 762. [Abstract] [Full Text] [PDF]

				R. Sauni, R Jarvenpaa, E Iivonen, S Nevalainen, and J Uitti Pulmonary alveolar proteinosis induced by silica dust? Occup. Med., May 1, 2007; 57(3): 221 - 224. [Abstract] [Full Text] [PDF]

				O C Ioachimescu and M S Kavuru Pulmonary alveolar proteinosis Chronic Respiratory Disease, July 1, 2006; 3(3): 149 - 159. [Abstract] [PDF]

				W. R. Webb Thin-Section CT of the Secondary Pulmonary Lobule: Anatomy and the Image--The 2004 Fleischner Lecture Radiology, May 1, 2006; 239(2): 322 - 338. [Abstract] [Full Text] [PDF]

				A. Perez IV, H. O. Coxson, J. C. Hogg, K. Gibson, P. F. Thompson, and R. M. Rogers Use of CT Morphometry To Detect Changes in Lung Weight and Gas Volume Chest, October 1, 2005; 128(4): 2471 - 2477. [Abstract] [Full Text] [PDF]

				J. F. Seymour and J. J. Presneill Pulmonary Alveolar Proteinosis: Progress in the First 44 Years Am. J. Respir. Crit. Care Med., July 15, 2002; 166(2): 215 - 235. [Abstract] [Full Text] [PDF]