Department of Radiology.
Department of Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
J Thorac Imaging. 2023 Nov 1;38(Suppl 1):S19-S29. doi: 10.1097/RTI.0000000000000728. Epub 2023 Jul 12.
Idiopathic interstitial pneumonias (IIPs) are a group of diffuse parenchymal lung diseases of unclear etiology and are distinguished from diffuse parenchymal lung diseases of known cause, such as connective tissue disease-related interstitial lung diseases or hypersensitivity pneumonitis by history, physical exam, imaging, serologic testing, and, when necessary, histopathology. The 2013 American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines are the most widely accepted classification of IIPs and include the following diagnoses: idiopathic pulmonary fibrosis, idiopathic nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, idiopathic lymphocytic interstitial pneumonia, idiopathic pleuro-parenchymal fibroelastosis, respiratory bronchiolitis-interstitial lung disease, and desquamative interstitial pneumonia. The gold standard for diagnosis of IIP involves multidisciplinary discussion among pulmonologists, radiologists, and pathologists. The focus of this review will be to discuss the imaging features of the most common IIPs and the role of multidisciplinary discussion as the gold standard for diagnosis.
特发性间质性肺炎(IIPs)是一组病因不明的弥漫性肺实质疾病,通过病史、体格检查、影像学、血清学检查以及必要时的组织病理学检查,与已知病因的弥漫性肺实质疾病(如结缔组织病相关的间质性肺疾病或过敏性肺炎)相区别。2013 年美国胸科学会(ATS)/欧洲呼吸学会(ERS)指南是最广泛接受的 IIP 分类,包括以下诊断:特发性肺纤维化、特发性非特异性间质性肺炎、隐源性机化性肺炎、急性间质性肺炎、特发性淋巴细胞性间质性肺炎、特发性胸膜肺弹力纤维增生症、呼吸细支气管炎-间质性肺疾病和脱屑性间质性肺炎。IIP 的诊断标准是由肺病学家、放射科医生和病理学家进行多学科讨论。本综述的重点将讨论最常见的 IIP 的影像学特征以及多学科讨论作为诊断金标准的作用。