hrct chest ground glass opacities
DESCRIPTION
Describing ground glassing on HRCT chest.TRANSCRIPT
![Page 1: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/1.jpg)
GROUND-GLASS OPACITIES
Dr.Mitusha Verma
![Page 2: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/2.jpg)
Definition…
• Non-specific increased opacity / hazziness of the lung parenchyma due to change in relative propotions of air and alveolar walls with preservation of bronchial and vascular markings.
![Page 3: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/3.jpg)
Pathologic basis
• Partial filling of air spaces with- fluid, macrophages,neutrophils, amorphus materials.
• Interstial thickening.
• Partial collapse of alveoli.
• Normal expiration.
• Increased capillary blood volume.
![Page 4: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/4.jpg)
False Positve / Pitfalls
• Artificial Blooming- Narrow window width.
• Volume averaging- Thicker collimation.
• Expiratory phase.
• Cardiac and Respiratory motion.
• Microatelectasis- In gravity dependent
positions.
![Page 5: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/5.jpg)
Patterns of GGO
GGO
DIFFUSE
BRONCHOVASCULAR
PERIPHERAL
PATCHY
FOCAL
Halo
![Page 6: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/6.jpg)
DIFFUSE
Acute lung transplant rejection.
ARDS
Edema
Extrinsic allergic alveolitis
Hemorrhage
Infectious pneumonia.
![Page 7: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/7.jpg)
Acute rejection of lung transplant
• HRCT 65% sensitive & 85% specific
•GGO
Mild rejection –Patchy & localisedSevere rejection –Widespread
DDs- Reperfusion edema Infections- CMV
![Page 8: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/8.jpg)
Acute Respiratory Distress Syndrome•Non Hydrosatatic pulmonary edema
•Leaky capillary membranes
•Etiology- Aspiration,contusion,smoke,sepsis.
•CT –Bilateral gravity dependentclung opacities.
![Page 9: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/9.jpg)
Pulmonary Edema
Venous / Lymphatic ostructionIncreased capillary permeabilityHypoproteinemia
CT- interlobular septal thickening increased vascular calibre peribronchovascular interstitial thickening, pleural effusion, thickening of fissures.
![Page 10: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/10.jpg)
Extrinsic allergic alveolitis
Also known as Hypersensitive Pneumonitis.
Complex immunologic reaction Of lung to inhaled organicAntigens.
Acute, Sub acute ,Chronic.
CT- GGO(82%) , Small Nodules,Reticular pattern,Air trapping.
![Page 11: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/11.jpg)
Diffuse Alveolar Haemorrhage
May be Diffuse , patchy or focal
Acute phase-GGO / Consolidation
Sub acute- uniformly distributed 1-3mmnodules with GGO & interstial septal thickening.
![Page 12: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/12.jpg)
Infectious Pneumonia
Bacterial, Viral, mycobacterial, Fungal, Parasitic.
A diffuse pattern – CMV & PCP
CMV with HIV -dense consolidation,Bronchiectasis,interstitial reticulations.
CMV post transplant - small nodules,Irregular lines.
![Page 13: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/13.jpg)
Infectious Pneumonia
Presence of isolated GGO
without additional findings in patient with AIDS highlysuggstive of Pneumocystis carinii.
![Page 14: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/14.jpg)
PatchyBronchiolitis obliterans organising pneumonia.
Bronchio-alveolar cell carcinoma.
Pulmonary alveolar proteinosis.
Acute lung transplant rejection.
ARDS
Extrinsic allergic alveolitis
Hemorrhage
Infectious pneumonia.
![Page 15: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/15.jpg)
Pulmonary alveolar proteinosis
Filling of alveoli with PAS positiveProteinacious material.
CT – Crazy paving
DDs- lipoid pneumonia,ARDS, PCP.
![Page 16: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/16.jpg)
FOCAL
Bronchoalveolar Lavage
Bronchiolitis obliterans organising pneumonia
Bronchio-alveolar carcinoma
Hemorrhage
Pulmonary infection.
![Page 17: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/17.jpg)
HALO Pattern
Invasive pulmonary aspergillosis
Neoplasm,haemorrhagic
Post-Biopsy pseudonodule.
![Page 18: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/18.jpg)
Invasive Aspergillosis.Peripheral ring of haemorrhageor haemorrhagic infarctionsurrounding target lesion of Aspergillosis.
![Page 19: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/19.jpg)
Peripheral Pattern.
Collagen vascular disease
Contusions
Desquamative interstitial pneumonitis
Drug toxicity
Eosinophilic pneumonia
Fibrosis
Sarcoidosis
BOOP.
![Page 20: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/20.jpg)
Bronchiolitis obliterans organising pneumonia.
Histologically- granulation tissue plugswithin respiratory bronchioles and alveolar ducts with Organising pneumonia extending into the surrounding alveoli.
CT –pachy GGO,nodules,consolidtion in peripheral distribution
Bilateral, non-segmental.
![Page 21: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/21.jpg)
Pulmonary contusions
Bleeding into lung interstitiumand air spaces.
CT- ill defined areas of GGO,Peripheral, non-anatomicdistribution.
![Page 22: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/22.jpg)
Desquamative interstitial pneumonitis
Alveoli filling with macrophages.
CT –lower lung zones peripheral
UIP –similar with morehoneycombing & tractionbronchiectasis.
![Page 23: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/23.jpg)
Collagen vascular disease
Multisystem disorders characterizedBy vascular changes, fibrosis,Inflammation of connective tissue.
SLE, RA , Polymyositis, Sjogren’s.
CT- GGO (63-100%)Is a sign of ACTIVE inflammationIn absence of significantHoneycombing, bronchiectasis,fibrosis.
Site of BiopsyTreatment Planning.Response to Treatment.
![Page 24: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/24.jpg)
Centrilobular / Bronchovascular
• Eosinophilic pneumonia
• Sarcoidosis
• Extrinsic allergic alveolitis
• Respiratory Bronchiolitis.
![Page 25: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/25.jpg)
To Conclude…
![Page 26: HRCT chest Ground glass opacities](https://reader036.vdocuments.site/reader036/viewer/2022081802/554b1084b4c9056f098b49de/html5/thumbnails/26.jpg)
• Thank you…