AJR Am J Roentgenol. 2023 Apr 12. doi: 10.2214/AJR.23.29119. Online ahead of print.
Pulmonary fibrosis is recognized to occur in association with a wide and increasing array of conditions, and presents with a spectrum of chest CT appearances. Idiopathic pulmonary fibrosis (IPF), corresponding histologically with usual interstitial pneumonia and representing the most common idiopathic interstitial pneumonia, is a chronic progressive fibrotic interstitial lung disease (ILD) of unknown cause. Progressive pulmonary fibrosis (PPF) describes the radiologic development of pulmonary fibrosis in patients with ILD of a known or unknown cause other than IPF. The recognition of PPF impacts management of patients with ILD, for example guiding initiation of antifibrotic therapy. Interstitial lung abnormalities (ILAs) represent an incidental CT finding in patients without suspected ILD and may represent an early intervenable form of pulmonary fibrosis. Traction bronchiectasis and/or bronchiolectasis, when detected in the setting of chronic fibrosis, is generally considered evidence of irreversible disease, and progression predicts worse mortality. Awareness is increasing of the relation between pulmonary fibrosis and connective tissue diseases, particularly rheumatoid arthritis. This review provides an update on imaging of pulmonary fibrosis, with attention to recent advances in disease understanding with relevance to radiologic practice. The essential role of a multidisciplinary approach to clinical and radiologic data is highlighted.
PMID:37095673 | DOI:10.2214/AJR.23.29119