Imaging

Pulmonary Fibrosis

Preliminary Diagnosis: Pulmonary Fibrosis

I. What imaging technique is first-line for this diagnosis?

Chest x-ray, PA, and lateral view.

II. Describe the advantages and disadvantages of this technique for diagnosing pulmonary fibrosis.

Advantages

  • Highly portable.

  • Relatively inexpensive and exposes patients to minimal ionizing radiation.

Disadvantages

  • Less sensitive and specific in detailing the underlying parenchyma and pleura or detecting and characterizing any secondary pulmonary complications compared to companion cross sectional CT imaging.

  • Less adept in characterizing parenchymal architecture or specific abnormalities of the secondary pulmonary lobule.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist. Some institutions may require consent for pregnant patients.

IV. What alternative imaging techniques are available?

CT/high resolution CT of the chest without contrast.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing pulmonary fibrosis.

Advantages

  • Highly sensitive and specific in detecting and characterizing any primary parenchymal or pleural abnormality and characterizing any secondary complication.

  • Offers exquisite detail of the underlying lung architecture, with particular focus on the secondary pulmonary lobule.

  • May help guide treatment.

  • May help determine the chronicity of an interstitial pulmonary process.

Disadvantages

  • Exposes patients to significantly more ionizing radiation than plain radiography.

  • More expensive and less portable compared to plain radiography.

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.

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