Computed Tomography of the Lung: A Pattern Approach

Computed Tomography of the Lung: A Pattern Approach

Most radiologists are involved on a daily basis in the performance and interpretation of CT studies of the lung, one of the most frequent radiological examinations in routine practice.
The currently available state-of-the-art MDCT technology enables us to study and display lung anatomy and gross pathology up to the level of the secondary pulmonary nodule in an exquisite way. Prof. J.A. Verschakelen and Dr. W. De Wever have taken an original but highly didactic approach to explaining and teaching the CT features of lung diseases and other diseases with a pulmonary component.
The numerous superb colour drawings, together with the well chosen high resolution CT images, enable the reader to better understand the CT changes in patients with pulmonary diseases, to recognise characteristic appearances and distribution patterns of the lung parenchyma, and finally how to use these patterns to make a correct diagnosis or to narrow down the number of differential diagnostic possibilities. The fact that all chapters of this book have been authored by the two editors only ensures that the specific concept and approach of this book is well respected throughout the whole volume.

I congratulate the authors, both internationally well known chest radiologists, for writing this excellent and remarkable work. I can strongly recommend it to all trainees in radiology and pneumology, as it provides a perfect guide through the field of HRCT of the lung, as well as to certified medical specialists who want to update their knowledge in CT of the lung. I am confident that this volume will meet with the same success among readers as many of the previous volumes published in this series.

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 confirmed 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 field of crosssectional imaging and also has significant 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 definitive diagnosis, once the CT findings 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

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