Skip to main content
Erschienen in: Der Radiologe 9/2009

01.09.2009 | CME Weiterbildung • Zertifizierte Fortbildung

Das retikuläre Muster in der Dünnschicht-CT

Von der Morphologie zur Differenzialdiagnose

verfasst von: PD Dr. K. Marten

Erschienen in: Die Radiologie | Ausgabe 9/2009

Einloggen, um Zugang zu erhalten

Zusammenfassung

Das retikuläre Muster in der Dünnschicht-CT umfasst als Hauptkomponenten die verdickten interlobulären und intralobulären Septen sowie das Honeycombing. Wenn verdickte interlobuläre Septen bzw. Honeycombing CT-morphologisch im Vordergrund stehen, ist eine weitgehende differenzialdiagnostische Eingrenzung der in Frage kommenden interstitiellen Lungenerkrankungen möglich. Hierbei ist wichtig, eine genaue Analyse von morphologischen Charakteristika (z. B. glatt oder nodulär verdickte interlobuläre Septen) und der Befundlokalisation (z. B. peripher, basal und subpleural lokalisiertes Honeycombing) vorzunehmen. Verdickte intralobuläre Septen sind, wie auch Parenchymbänder, subpleurale Linien und das sog. „Grenzflächenzeichen“ dagegen eher unspezifische Befunde, die jedoch in Zusammenschau mit weiteren CT-morphologischen Charakteristika ebenfalls eine weitgehende differenzialdiagnostische Einschätzung ermöglichen.
Literatur
1.
Zurück zum Zitat Aberle DR, Gamsu G, Ray CS (1988) Asbestos-related pleural and parenchymal fibrosis: Detection with high-resolution CT. Radiology 166:729–734PubMed Aberle DR, Gamsu G, Ray CS (1988) Asbestos-related pleural and parenchymal fibrosis: Detection with high-resolution CT. Radiology 166:729–734PubMed
2.
Zurück zum Zitat Adler BD, Padley SP, Müller NL et al (1992) Chronic hypersensitivity pneumonitis: High-resolution CT and radiographic features in 16 patients. Radiology 185:91–95PubMed Adler BD, Padley SP, Müller NL et al (1992) Chronic hypersensitivity pneumonitis: High-resolution CT and radiographic features in 16 patients. Radiology 185:91–95PubMed
3.
Zurück zum Zitat Al-Jarad N, Strickland B, Pearson MC (1992) High-resolution computed tomographic assessment of asbestosis and cryptogenic fibrosing alveolitis: A comparative study. Thorax 47:645–650PubMedCrossRef Al-Jarad N, Strickland B, Pearson MC (1992) High-resolution computed tomographic assessment of asbestosis and cryptogenic fibrosing alveolitis: A comparative study. Thorax 47:645–650PubMedCrossRef
4.
Zurück zum Zitat Cassart M, Genevois PA, Kramer M et al (1993) Pulmonary venoocclusive disease: CT findings before and after single-lung transplantation. AJR Am J Roentgenol 160:759–760PubMed Cassart M, Genevois PA, Kramer M et al (1993) Pulmonary venoocclusive disease: CT findings before and after single-lung transplantation. AJR Am J Roentgenol 160:759–760PubMed
5.
Zurück zum Zitat Copley SJ, Wells AU, Sivakumaran P et al (2003) Asbestosis and idiopathic pulmonary fibrosis: Comparison of thin-section CT features. Radiology 229:731–736PubMedCrossRef Copley SJ, Wells AU, Sivakumaran P et al (2003) Asbestosis and idiopathic pulmonary fibrosis: Comparison of thin-section CT features. Radiology 229:731–736PubMedCrossRef
6.
Zurück zum Zitat Desai SR, Wells AU, Rubens MB et al (1999) Acute respiratory distress syndrome: CT abnormalities at long-term follow up. Radiology 210:29–35PubMed Desai SR, Wells AU, Rubens MB et al (1999) Acute respiratory distress syndrome: CT abnormalities at long-term follow up. Radiology 210:29–35PubMed
7.
Zurück zum Zitat Genereux GP (1975) The end-stage lung: pathogenesis, pathology, and radiology. Radiology 116:279–289PubMed Genereux GP (1975) The end-stage lung: pathogenesis, pathology, and radiology. Radiology 116:279–289PubMed
8.
Zurück zum Zitat Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner society: Glossary of terms for thoracic imaging. Radiology 246:697–722PubMedCrossRef Hansell DM, Bankier AA, MacMahon H et al (2008) Fleischner society: Glossary of terms for thoracic imaging. Radiology 246:697–722PubMedCrossRef
9.
Zurück zum Zitat Heyneman LE, Johkoh T, Ward S et al (2000) Pulmonary leukemic infiltrates: High-resolution CT findings in 10 patients. AJR Am J Roentgenol 174:517–521PubMed Heyneman LE, Johkoh T, Ward S et al (2000) Pulmonary leukemic infiltrates: High-resolution CT findings in 10 patients. AJR Am J Roentgenol 174:517–521PubMed
10.
Zurück zum Zitat Hunninghake GW, Lynch DA, Galvin JR et al (2003) Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia. Chest 124:1215–1223PubMedCrossRef Hunninghake GW, Lynch DA, Galvin JR et al (2003) Radiologic findings are strongly associated with a pathologic diagnosis of usual interstitial pneumonia. Chest 124:1215–1223PubMedCrossRef
11.
Zurück zum Zitat Ichikawa Y, Kinoshita M, Koga T et al (1994) Lung cyst formation in lymphocytic interstitial pneumonia: CT features. J Comput Assist Tomogr 18:745–748PubMedCrossRef Ichikawa Y, Kinoshita M, Koga T et al (1994) Lung cyst formation in lymphocytic interstitial pneumonia: CT features. J Comput Assist Tomogr 18:745–748PubMedCrossRef
12.
Zurück zum Zitat Johkoh T, Ikezoe J, Tomiyama N et al (1992) CT findings in lymphangitic carcinomatosis of the lung: Correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol 145:505–510 Johkoh T, Ikezoe J, Tomiyama N et al (1992) CT findings in lymphangitic carcinomatosis of the lung: Correlation with histologic findings and pulmonary function tests. AJR Am J Roentgenol 145:505–510
13.
Zurück zum Zitat Johkoh T, Müller NL, Cartier Y et al (1999) Idiopathic interstitial pneumonia: Diagnostic accuracy of thin-section CT in 129 patients. Radiology 211:55–560 Johkoh T, Müller NL, Cartier Y et al (1999) Idiopathic interstitial pneumonia: Diagnostic accuracy of thin-section CT in 129 patients. Radiology 211:55–560
14.
Zurück zum Zitat Johkoh T, Müller NL, Pickford HA et al (1999) Lymphocytic interstitial pneumonia: Thin-section CT findings in 22 patients. Radiology 212:567–572PubMed Johkoh T, Müller NL, Pickford HA et al (1999) Lymphocytic interstitial pneumonia: Thin-section CT findings in 22 patients. Radiology 212:567–572PubMed
15.
Zurück zum Zitat Kim TS, Lee KS, Chung MP et al (1998) Nonspecific interstitial pneumonia with fibrosis: High-resolution CT and pathologic findings. AJR Am J Roentgenol 171:1645–1650PubMed Kim TS, Lee KS, Chung MP et al (1998) Nonspecific interstitial pneumonia with fibrosis: High-resolution CT and pathologic findings. AJR Am J Roentgenol 171:1645–1650PubMed
16.
Zurück zum Zitat Lee KS, Kim Y, Primack SL (1997) Imaging of pulmonary lymphomas. AJR Am J Roentgenol 168:339–345PubMed Lee KS, Kim Y, Primack SL (1997) Imaging of pulmonary lymphomas. AJR Am J Roentgenol 168:339–345PubMed
17.
Zurück zum Zitat Leung AN, Staples CA, Müller NL (1991) Chronic diffuse infiltrative lung disease: Comparison of diagnostic accuracy of high-resolution and conventional CT. AJR Am J Roentgenol 157:693–696PubMed Leung AN, Staples CA, Müller NL (1991) Chronic diffuse infiltrative lung disease: Comparison of diagnostic accuracy of high-resolution and conventional CT. AJR Am J Roentgenol 157:693–696PubMed
18.
Zurück zum Zitat Lynch DA, Gamsu G, Ray CS, Aberle D (1988) Asbestos-related focal lung masses: Manifestations on conventional and high-resolution CT scans. Radiology 160:603–607 Lynch DA, Gamsu G, Ray CS, Aberle D (1988) Asbestos-related focal lung masses: Manifestations on conventional and high-resolution CT scans. Radiology 160:603–607
19.
Zurück zum Zitat Lynch DA, Godwin JD, Safrin S et al (2005) High-resolution computed tomography in idiopathic pulmonary fibrosis: Diagnosis and prognosis. Am J Respir Crit Care Med 172:488–493PubMedCrossRef Lynch DA, Godwin JD, Safrin S et al (2005) High-resolution computed tomography in idiopathic pulmonary fibrosis: Diagnosis and prognosis. Am J Respir Crit Care Med 172:488–493PubMedCrossRef
20.
Zurück zum Zitat Mathieson JR, Mayo JR, Staples CA, Müller NL (1989) Chronic diffuse infiltrative lung disease: Comparison of diagnostic accuracy of CT and chest radiography. Radiology 171:111–116PubMed Mathieson JR, Mayo JR, Staples CA, Müller NL (1989) Chronic diffuse infiltrative lung disease: Comparison of diagnostic accuracy of CT and chest radiography. Radiology 171:111–116PubMed
21.
Zurück zum Zitat McGuinness G, Scholes JV, Jagirdar JS et al (1995) Unusual lymphoproliferative disorders in nine adults with HIV or AIDS: CT and pathologic findings. Radiology 197:59–65PubMed McGuinness G, Scholes JV, Jagirdar JS et al (1995) Unusual lymphoproliferative disorders in nine adults with HIV or AIDS: CT and pathologic findings. Radiology 197:59–65PubMed
22.
Zurück zum Zitat Müller NL, Kullnig P, Miller RR (1989) The CT findings of pulmonary sarcoidosis: Analysis of 25 patients. AJR Am J Roentgenol 152:1179–1182PubMed Müller NL, Kullnig P, Miller RR (1989) The CT findings of pulmonary sarcoidosis: Analysis of 25 patients. AJR Am J Roentgenol 152:1179–1182PubMed
23.
Zurück zum Zitat Munk PL, Müller NL, Miller RR (1988) Pulmonary lymphangitic carcinomatosis: CT and pathologic findings. Radiology 166:705–709PubMed Munk PL, Müller NL, Miller RR (1988) Pulmonary lymphangitic carcinomatosis: CT and pathologic findings. Radiology 166:705–709PubMed
24.
Zurück zum Zitat Murch CR, Carr DH (1989) Computed tomography appearances of pulmonary alveolar proteinosis. Clin Radiol 40:240–243PubMedCrossRef Murch CR, Carr DH (1989) Computed tomography appearances of pulmonary alveolar proteinosis. Clin Radiol 40:240–243PubMedCrossRef
25.
Zurück zum Zitat Nishimura K, Kitaichi M, Izumi T et al (1992) Usual interstitial pneumonia: Histologic correlation with high-resolution CT. Radiology 182:337–342PubMed Nishimura K, Kitaichi M, Izumi T et al (1992) Usual interstitial pneumonia: Histologic correlation with high-resolution CT. Radiology 182:337–342PubMed
26.
Zurück zum Zitat Nishimura K, Izumi T, Kitaichi M et al (1993) The diagnostic accuracy of high-resolution computed tomography in diffuse infiltrative lung diseases. Chest 104:1149–1155PubMedCrossRef Nishimura K, Izumi T, Kitaichi M et al (1993) The diagnostic accuracy of high-resolution computed tomography in diffuse infiltrative lung diseases. Chest 104:1149–1155PubMedCrossRef
27.
Zurück zum Zitat Padley SPG, Hansell DM, Flower CDR, Jennings P (1991) Comparative accuracy of high resolution computed tomography and chest radiography in the diagnosis of chronic diffuse infiltrative lung disease. Clin Radiol 44:222–226PubMedCrossRef Padley SPG, Hansell DM, Flower CDR, Jennings P (1991) Comparative accuracy of high resolution computed tomography and chest radiography in the diagnosis of chronic diffuse infiltrative lung disease. Clin Radiol 44:222–226PubMedCrossRef
28.
Zurück zum Zitat Primack SL, Hartman TE, Hansell DM (1993) End-stage lung disease: CT findings in 61 patients. Radiology:189:681–686 Primack SL, Hartman TE, Hansell DM (1993) End-stage lung disease: CT findings in 61 patients. Radiology:189:681–686
29.
Zurück zum Zitat Reuter M (2009) Mustererkennung im HRCT der Lunge. Radiologe (im Druck) Reuter M (2009) Mustererkennung im HRCT der Lunge. Radiologe (im Druck)
30.
Zurück zum Zitat Rossi SE, Erasmus JJ, Volpacchio M et al (2003) „Crazy-paving” pattern at thin-section CT of the lungs: Radiologic-pathologic overview. Radiographics 23:1509–1519PubMedCrossRef Rossi SE, Erasmus JJ, Volpacchio M et al (2003) „Crazy-paving” pattern at thin-section CT of the lungs: Radiologic-pathologic overview. Radiographics 23:1509–1519PubMedCrossRef
31.
Zurück zum Zitat Schurawitzki H, Stiglbauer R, Graininger W et al (1990) Interstitial lung disease in progressive systemic sclerosis: High-resolution CT versus radiography. Radiology 176:755–759PubMed Schurawitzki H, Stiglbauer R, Graininger W et al (1990) Interstitial lung disease in progressive systemic sclerosis: High-resolution CT versus radiography. Radiology 176:755–759PubMed
32.
Zurück zum Zitat Stein MG, Mayo J, Müller NL et al (1987) Pulmonary lymphangitic spread of carcinoma: Appearance on CT scans. Radiology 162:371–375PubMed Stein MG, Mayo J, Müller NL et al (1987) Pulmonary lymphangitic spread of carcinoma: Appearance on CT scans. Radiology 162:371–375PubMed
33.
Zurück zum Zitat Storto ML, Kee ST, Golden JA, Webb DR (1995) Hydrostatic pulmonary edema: high-resolution CT findings. AJR Am J Roentgenol 165:817–820PubMed Storto ML, Kee ST, Golden JA, Webb DR (1995) Hydrostatic pulmonary edema: high-resolution CT findings. AJR Am J Roentgenol 165:817–820PubMed
34.
Zurück zum Zitat Swensen SJ, Aughenbaugh GL, Myers JL (1997) Diffuse lung disease: Diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung. Radiology 205:229–234PubMed Swensen SJ, Aughenbaugh GL, Myers JL (1997) Diffuse lung disease: Diagnostic accuracy of CT in patients undergoing surgical biopsy of the lung. Radiology 205:229–234PubMed
35.
Zurück zum Zitat Webb RW, Müller NL, Naidich DP (2001) High-resolution computed tomography findings of lung disease. In: Webb RW, Müller NL, Naidich DP (Hrsg) High-resolution CT of the lung. Lippincott Williams & Wilkins, Philadelphia, USA, p 72 Webb RW, Müller NL, Naidich DP (2001) High-resolution computed tomography findings of lung disease. In: Webb RW, Müller NL, Naidich DP (Hrsg) High-resolution CT of the lung. Lippincott Williams & Wilkins, Philadelphia, USA, p 72
36.
Zurück zum Zitat Zerhouni EA, Naidich DP, Stitik FP (1985) Computed tomography of the pulmonary parenchyma: Part 2. Interstitial disease. J Thorac Imaging 1:54–64PubMedCrossRef Zerhouni EA, Naidich DP, Stitik FP (1985) Computed tomography of the pulmonary parenchyma: Part 2. Interstitial disease. J Thorac Imaging 1:54–64PubMedCrossRef
Metadaten
Titel
Das retikuläre Muster in der Dünnschicht-CT
Von der Morphologie zur Differenzialdiagnose
verfasst von
PD Dr. K. Marten
Publikationsdatum
01.09.2009
Verlag
Springer-Verlag
Erschienen in
Die Radiologie / Ausgabe 9/2009
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-009-1829-8

Weitere Artikel der Ausgabe 9/2009

Der Radiologe 9/2009 Zur Ausgabe

Journal Club

CT-Diagnostik

Berufsverband der Deutschen Radiologen (BDR) - Mitteilungen

Mitteilungen des BDR, Heft 9/2009

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.