Seminars in Roentgenology最新文献_第2页

Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach 改进肺泡蛋白沉积症的放射学识别：一种疯狂铺路模式方法。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-10-07 DOI: 10.1053/j.ro.2025.09.004

Aaron Cedric Llanes , Anshu Bandhlish , Sudhakar Pipavath , Ana Paula Santos Lima

{"title":"Refining the Radiologic Recognition of Pulmonary Alveolar Proteinosis: A Crazy-Paving Pattern Approach","authors":"Aaron Cedric Llanes , Anshu Bandhlish , Sudhakar Pipavath , Ana Paula Santos Lima","doi":"10.1053/j.ro.2025.09.004","DOIUrl":"10.1053/j.ro.2025.09.004","url":null,"abstract":"<div><div>Pulmonary alveolar proteinosis (PAP) is a rare airspace disease classically associated with the crazy-paving pattern on high-resolution computed tomography (HRCT). While highly suggestive, this imaging pattern is not pathognomonic and appears across a wide spectrum of pulmonary pathologies. In this review, we adopt a phenotype-first approach, using representative imaging cases to walk the reader through the differential diagnosis of crazy-paving, with attention to radiologic distribution, clinical context, and disease acuity. We emphasize distinguishing features between PAP and its mimics—including pulmonary edema, diffuse alveolar hemorrhage, organizing pneumonia, mucinous adenocarcinoma, exogenous lipoid pneumonia, acute fulminant PAP, and COVID-19 pneumonia—using side-by-side imaging and contextual pearls. Special attention is given to the radiologic clues favoring autoimmune versus secondary PAP, including geographic distribution of ground-glass opacities, subpleural sparing, and lower lobe predominance. The review concludes with a summary of diagnostic strategies, pathologic correlation, and treatment options, including insights from post-pandemic diagnostic pitfalls. This pattern-based framework is designed for the radiologist and serves as a practical guide for recognizing PAP within the broader spectrum of airspace diseases.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"61 ","pages":"Article 150961"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleuroparenchymal Fibroelastosis

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-23 DOI: 10.1053/j.ro.2025.08.002

Elizabeth Lee MD , Heather Chen-Yost MD , Jennifer M. Wang MD , Prachi P. Agarwal MBBS

引用次数: 0

ILD Imaging: Beyond Patterns to Patient-Centered Care ILD成像：超越模式到以患者为中心的护理。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-23 DOI: 10.1053/j.ro.2025.09.001

Prachi Agarwal MD, MD, FNASCI, FACR

引用次数: 0

Hypersensitivity Pneumonitis: Imaging Findings and Patterns 超敏性肺炎：影像学表现和模式。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-08-29 DOI: 10.1053/j.ro.2025.08.001

Taylor Sellers MD, Maria Daniela Martin MD, Jeffrey P. Kanne MD

{"title":"Hypersensitivity Pneumonitis: Imaging Findings and Patterns","authors":"Taylor Sellers MD, Maria Daniela Martin MD, Jeffrey P. Kanne MD","doi":"10.1053/j.ro.2025.08.001","DOIUrl":"10.1053/j.ro.2025.08.001","url":null,"abstract":"<div><div>Recently published guidelines on the diagnosis of hypersensitivity pneumonitis from the American Thoracic Society/Japanese Respiratory Society/Asociación Latinoamericana de Tórax and the American College of Chest Physicians place increased importance on CT analysis as a component of the multidisciplinary diagnosis. Accurate identification and characterization of CT findings is critical as they have downstream effects on the rest of the diagnostic workup, which places imaging early in their diagnostic algorithms. Though the imaging features of hypersensitivity pneumonitis are well established, it remains a challenging diagnosis for radiologists due to its variable appearance and lack of specific CT findings.</div><div>This review summarizes the imaging features and patterns of nonfibrotic and fibrotic hypersensitivity pneumonitis using the newest guidelines and classifications as a framework. Additional information relevant to the interpreting radiologist is also briefly discussed, including progressive pulmonary fibrosis, acute exacerbation, and differentiating fibrotic hypersensitivity pneumonitis from a usual interstitial pneumonia pattern of fibrosis.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"61 ","pages":"Article 150950"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interstitial Lung Abnormality: A Bayesian Approach for the Radiologist 肺间质性异常：放射科医生的贝叶斯方法。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-27 DOI: 10.1053/j.ro.2025.09.002

Nandakumar G. Patnam MD, Mohamed Abdelmotleb MD, Sudhakar Pipavath MD

{"title":"Interstitial Lung Abnormality: A Bayesian Approach for the Radiologist","authors":"Nandakumar G. Patnam MD, Mohamed Abdelmotleb MD, Sudhakar Pipavath MD","doi":"10.1053/j.ro.2025.09.002","DOIUrl":"10.1053/j.ro.2025.09.002","url":null,"abstract":"<div><div>Interstitial lung abnormalities (ILA) refer to incidental changes seen on chest CT, usually in people without a formal diagnosis of interstitial lung disease (ILD). Interest in ILA has grown in recent years, partly because they may signal early fibrotic lung changes and partly because CT scans are being used more often for screening. Defined by the Fleischner Society and updated by the ATS, ILA encompasses 3 patterns: nonsubpleural, subpleural nonfibrotic, and subpleural fibrotic. Subpleural fibrotic ILA, marked by traction bronchiectasis and honeycombing, carries the greatest likelihood of progression and the poorest prognosis. Older age, smoking history, and certain genetic traits such as the MUC5B promoter variant increase the likelihood of finding ILA. The presence of ILA also appears to raise the risk of lung cancer. For management, current guidelines recommend tailoring follow-up based on individual risk, with closer surveillance for patients more likely to progress. Newer tools, including quantitative imaging and artificial intelligence, may help detect subtle disease earlier and refine risk assessment. Despite advances, challenges remain in defining progression thresholds and treatment strategies, highlighting the need for further research.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"61 ","pages":"Article 150959"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Organizing Pneumonia Phenotype 组织性肺炎表型。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-25 DOI: 10.1053/j.ro.2025.08.007

Muthu Kumar Sakthivel MD, FSCMR , Todd Richard Hazelton MD, MS , Frederic Barton Askin MD , Surekha Bantumilli MD , Shravan Sridhar MD, MS

引用次数: 0

Usual Interstitial Pneumonia Spectrum: UIP, Probable UIP, and Indeterminate UIP 通常间质性肺炎谱：UIP、可能UIP和不确定UIP。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI: 10.1053/j.ro.2025.09.005

Furkan Ufuk MD, Lydia Chelala MD, Jonathan H. Chung MD

{"title":"Usual Interstitial Pneumonia Spectrum: UIP, Probable UIP, and Indeterminate UIP","authors":"Furkan Ufuk MD, Lydia Chelala MD, Jonathan H. Chung MD","doi":"10.1053/j.ro.2025.09.005","DOIUrl":"10.1053/j.ro.2025.09.005","url":null,"abstract":"<div><div>The usual interstitial pneumonia (UIP) pattern remains central to the diagnosis and management of fibrotic interstitial lung diseases (ILDs), particularly idiopathic pulmonary fibrosis (IPF). Thin-section computed tomography enables noninvasive characterization across the UIP spectrum, with structured pattern classification demonstrating strong correlation with histopathology and survival outcomes. In appropriate clinical settings, thin-section CT can obviate the need for surgical lung biopsy. Multidisciplinary discussion remains essential to integrate imaging, clinical, and pathologic findings for optimal therapeutic decision-making, including timely antifibrotic initiation and transplant referral. This review synthesizes current knowledge on the UIP imaging spectrum, emphasizing its diagnostic, prognostic, and clinical implications. We further outline recent advances in quantitative imaging, deep learning models, and molecular biomarkers that improve diagnostic precision and risk stratification. We also highlight emerging frontiers, including AI-driven spatiotemporal modeling and molecular imaging, that promise earlier detection, individualized prognostication, and precision-guided therapy.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"61 ","pages":"Article 150962"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Radiologic Approach to Cystic Lung Diseases: From Cyst Definition to Diagnosis 肺囊性疾病的影像学诊断：从囊肿定义到诊断。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-26 DOI: 10.1053/j.ro.2025.08.005

Harish Gudi MD , Dhiraj Baruah MD , Kavitha Yaddanapudi MD , Ismail M Kabakus MD, PhD

{"title":"Radiologic Approach to Cystic Lung Diseases: From Cyst Definition to Diagnosis","authors":"Harish Gudi MD , Dhiraj Baruah MD , Kavitha Yaddanapudi MD , Ismail M Kabakus MD, PhD","doi":"10.1053/j.ro.2025.08.005","DOIUrl":"10.1053/j.ro.2025.08.005","url":null,"abstract":"<div><div>Cystic lung diseases represent a heterogeneous group of conditions characterized by the presence of multiple pulmonary cysts. Accurate recognition and differentiation of true cysts from their mimics (such as cavities, emphysema, bullae, blebs, and honeycombing) are essential, as management strategies and prognoses vary significantly. This review provides a systematic approach to the radiologic evaluation of cystic lung diseases, beginning with the definition and pathogenesis of pulmonary cysts and progressing through a structured diagnostic algorithm. We detail the characteristic imaging findings and clinical associations for major cystic lung diseases, including lymphangioleiomyomatosis (LAM), Birt-Hogg-Dubé syndrome (BHD), light-chain deposition disease (LCDD), lymphocytic interstitial pneumonia (LIP), desquamative interstitial pneumonia (DIP), pulmonary Langerhans cell histiocytosis (PLCH), and amyloidosis. Additionally, we discuss uncommon etiologies, such as cystic metastases, hypersensitivity pneumonitis, and cystic changes associated with genetic syndromes like neurofibromatosis type 1 (NF-1) and trisomy 21. The review emphasizes key imaging clues, such as cyst distribution, wall characteristics, associated nodules, and parenchymal abnormalities, that aid in narrowing the differential diagnosis. With the growing use of CT imaging, cystic lung diseases are increasingly identified in both symptomatic and asymptomatic patients. Familiarity with their imaging patterns, clinical contexts, and distinguishing features is essential for radiologists and clinicians alike. By following a stepwise, pattern-based approach, early and accurate diagnosis can be achieved, potentially improving patient outcomes through timely surveillance and targeted management.</div></div>","PeriodicalId":51151,"journal":{"name":"Seminars in Roentgenology","volume":"61 ","pages":"Article 150954"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Progressive Massive Fibrosis Phenotype: Causes, Pathophysiology, and Imaging 进行性块状纤维化表型：病因、病理生理学和影像学。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI: 10.1053/j.ro.2025.08.006

Leif Jensen MD, MPH , Cris A. Meyer MD

引用次数: 0

Autoimmune-Associated Interstitial Lung Disease: Imaging Phenotypes 自身免疫相关间质性肺疾病：影像学表型。

IF 1.3 4区医学

Seminars in Roentgenology Pub Date : 2026-01-01 Epub Date: 2025-09-26 DOI: 10.1053/j.ro.2025.08.003

Christian W. Cox MD

引用次数: 0