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Computed tomography is generally considered to be the best imaging modality for the
assessment of the lung parenchyma. High resolution computed tomography (HRCT)
is able to provide very high morphological detail of the normal and abnormal lung
parenchyma and has been widely accepted as the imaging gold standard for the lung
parenchyma. Many reports have confi rmed the high diagnostic value of this technique,
especially in the study of widespread diffuse or generalized lung disease, which is due to
the HRCT protocol obtaining images at 10- or 20-mm intervals. Spiral CT, and especially
multidetector-row spiral CT, has brought about enormous change in the fi eld of crosssectional
imaging and also has signifi cant potential for the study of the lung parenchyma.
This procedure is indeed able to generate volumetric high-resolution CT which
provides a contiguous, detailed visualisation of the lung parenchyma. This visualisation
is no longer limited to the axial plane since multiplanar reformations and three-dimensional
volume reconstructions can easily be performed. In addition, high detail imaging
of the lung parenchyma is no longer reserved for the less frequently occurring diffuse
and interstitial lung diseases, but has now become available for the study of all lung
diseases.
Optimal use and interpretation of CT requires good knowledge and understanding of
how the normal lung parenchyma looks on CT, why and how this lung parenchyma may
be affected by disease and how these changes are visualised on a CT image. Furthermore,
in order to have a fruitful discussion with the clinician taking care of the patient and,
when appropriate, with the pathologist, it is important that the radiologist knows and
understands why abnormalities appear as they do.
Giving the readers a clear understanding of why abnormalities appear as they do is
indeed one of the main goals of this book, since this skill will enable them to choose an
appropriate differential diagnosis or even suggest a defi nitive diagnosis, once the CT
fi ndings have been correlated with the clinical situation.
We have opted for a concise and didactic approach by reducing the vast amount of
information available on this topic to what we think is basic and essential knowledge
that allows to recognise and understand the CT signs of lung diseases and of diseases
with pulmonary involvement. We have used the pattern approach because it is well
established and it is considered a good method to accomplish the main goal of the book.
Our approach also has a practical orientation. For this reason, a large section of the book
is dedicated to the description of typical and less typical cases. Analyzing these cases
will help the reader to exercise pattern recognition and to understand why the diseases
present as they do. |
