High Resolution Computed Tomography of Diffuse Pediatric Pulmonary Diseases

  • J. P. Kuhn
Conference paper
Part of the Syllabus book series (SYLLABUS)


High resolution computed tomography (HRCT) is used to maximize spatial resolution in the lung. Most authors define this technique as the combined use of images of 1–3 mm collimation and a high spatial frequency (edge-enhancing algorithm), which on many scanners is called the “bone algorithm”. When used together, these two factors result in images of the lung that approximate the appearance of a gross anatomic specimen [1, 2]. Despite intense interest and experience with this technique in diseases affecting adults, there remains little information in the literature regarding application of this technique to diseases of the child’s lung [3–6].


High Resolution Compute Tomography Obliterative Bronchiolitis Pulmonary Alveolar Proteinosis Lymphomatoid Granulomatosis Secondary Pulmonary Lobule 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Webb WR, Stein MG, Finkbeiner WE, et al. (1988) Normal and diseased isolated lungs: high-resolution CT. Radiology 166: 81PubMedGoogle Scholar
  2. 2.
    Bessis L, Callard P, Gotheil C, Biaggi A, Grenier P (1992) High-resolution CT of parenchymal lung disease: precise correlation with histologic findings. Radiographics 12: 45–58PubMedGoogle Scholar
  3. 3.
    Kuhn JP (1993) High-resolution computed tomography of pediatric pulmonary parenchymal disorders. Radiol Clin North Am 31: 533–551PubMedGoogle Scholar
  4. 4.
    Moon WK, Kim WS, Kim IO, Im JG, Yeon KM, Han MC (1996) Diffuse pulmonary disease in children: high-resolution CT findings. AJR 167: 1405–1408PubMedGoogle Scholar
  5. 5.
    Seely JM, Effmann EL, Muller NL (1997) High-resolution CT of pediatric lung disease: imaging findings. AJR 168: 1269–1275PubMedGoogle Scholar
  6. 6.
    Kuhn JP, Slovis TL, Silverman FN, Kuhns LR (1993) The neck and respiratory system. In: Silverman FN, Kuhn JP (eds) Caffey’s pediatric X-ray diagnosis. Mosby. St. Louis, pp 345–697Google Scholar
  7. 7.
    Webb WR, Muller NL, Naidich DP (1996) High-resolution CT of the lung, 2nd ed. Lippincott-Raven, New York, pp 4–13Google Scholar
  8. 8.
    Mayo JR, Webb WR, Gould R, et al. (1987) High-resolution CT of the lungs: an optimal approach. Radiology 163: 507PubMedGoogle Scholar
  9. 9.
    Murata K, Khan A, Rojas KA, et al. (1988) Optimization of computed tomography technique to demonstrate the fine structure of the lung. Invest Radiol 23: 170PubMedCrossRefGoogle Scholar
  10. 10.
    Naidich DP, Marshal CH, Gribbin C, et al. (1990) Low-dose CT of the lungs: preliminary observations. Radiology 175: 729PubMedGoogle Scholar
  11. 11.
    Ambrosino MM, Genieser NB, Roche KJ, Kaul A, Lawrence RM (1994) Feasibility of high-resolution, low-dose chest CT in evaluating the pediatric chest. Pediatr Radiol 24: 6–10PubMedCrossRefGoogle Scholar
  12. 12.
    Naidich DP, Muller NL, Zerhouni EA, Webb WR, Krinsky GA, Siegelman SS, McGuinness G (1999) Computed tomography and magnetic resonance of the thorax. Lippincott-Raven, Philadelphia, pp 1–16Google Scholar
  13. 13.
    Kuhlman JE, Hruban RH, Fishman EK (1991) Wegener granulomatosis: CT features of parenchymal lung disease. J Comput Assist Tomogr 15: 948–952Google Scholar
  14. 14.
    Weibel ER, Bachofen H (1991) The fiber scaffold of lung parenchyma. In: Crystal RG, West JB (eds) The lung, Vol. 1. Raven Press, New York, pp 787–794Google Scholar
  15. 15.
    Weibel ER, Crystal RG (1991) Structural organization of the pulmonary interstitium. In: Crystal RG, West JB (eds) The lung, Vol. 1. Raven Press, New York, pp 369–380Google Scholar
  16. 16.
    Heitzman ER, Markarian B, Berger I, et al. (1969) The secondary pulmonary lobule: a practical concept for interpretation of chest radiographs. Radiology 93: 507–519PubMedGoogle Scholar
  17. 17.
    Bergin C, Roggli V, Coblentz C, et al. (1988) The secondary pulmonary lobule: normal and abnormal CT appearances. AJR 151: 21PubMedGoogle Scholar
  18. 18.
    Galvin JR, Mori M, Stanford W (1992) High-resolution computed tomography and diffuse lung disease. Curr Probl Diag Radiol 21: 31–74CrossRefGoogle Scholar
  19. 19.
    Lynch DA, Brasch RC, Hardy KA, et al. (1990) Pediatric pulmonary disease: assessment with high-resolution ultrafast CT. Radiology 176: 243PubMedGoogle Scholar
  20. 20.
    Naidich DP, Zerhouni EA, Hutchins GM, et al. (1985) Computed tomography of the pulmonary parenchyma: Part 2. Interstitial disease. J Thorac Imaging 1: 54Google Scholar
  21. 21.
    Naidich DP, Zerhouni EA, Hutchins GM, et al. (1985) Computed tomography of the pulmonary parenchyma: Part 1. Distal air-space disease. J Thorac Imaging 1: 39Google Scholar
  22. 22.
    Kuhn JP (1991) Pediatric thorax In: Naidich DP, Zerhouni EA, Siegelman S (eds) Computed tomography and magnetic resonance of the thorax, 2nd ed. Raven Press, New York, pp 503–555Google Scholar
  23. 23.
    Collins J, Stern EJ (1997) Ground-glass opacity at CT: the ABCs. AJR 169: 355–367PubMedGoogle Scholar
  24. 24.
    De Sena S, Rosenfeld DL, Santos S, Keller I (1996) Jugular thrombophlebitis complicating bacterial pharyngitis ( Lemierre’s syndrome ). Pediatr Radio! 26: 141–144Google Scholar
  25. 25.
    Gudinchet F, Maeder P, Neveceral P, Schnyder P (1997) Lemierre’s syndrome in children. High-resolution CT and color Doppler sonography patterns. Chest 112: 271–273Google Scholar
  26. 26.
    Helton KJ, Kuhn JP, Fletcher BD, et al. (1992) Bronchiolitis obliterans: organizing pneumonia ( BOOP) in children with malignant disease. Pediatr Radio] 22: 270–274Google Scholar
  27. 27.
    Akira M, Yamamoto S, Sakatani M (1998) Bronchiolitis obliterans organizing pneumonia manifesting as multiple large nodules or masses. AJR 170: 291–295PubMedGoogle Scholar
  28. 28.
    Inoue T, Toyoshima K, Kikui M (1996) Idiopathic bronchiolitis obliterans organizing pneumonia (idiopathic BOOP) in childhood. Pediatr Pulmonol 22: 67–72PubMedCrossRefGoogle Scholar
  29. 29.
    Arush MWB, Roguin A, Zamir E, El-Hassid R, Pries D, Gaitini D, Dale A, Postovsky S (1997) Bleomycin and cyclophosphamide toxicity simulating metastatic nodules to the lungs in childhood cancer. Pediatr Hematol Oncol 14: 381–386PubMedCrossRefGoogle Scholar
  30. 30.
    D’Alessandro MP, Kozakewich HPW, Cooke KR, Taylor GA (1996) Radiologic-pathologic conference of children’s hospital Boston: new pulmonary nodules in a child undergoing treatment for a solid malignancy. Pediatr Radiol 26: 19–21PubMedCrossRefGoogle Scholar
  31. 31.
    Logan PM, Primack SL, Miller RR, Muller NL (1994) Invasive aspergilliosis of the airways: radiographic, CT, and pathologic findings. Radiology 193: 383–388Google Scholar
  32. 32.
    Pearson ADJ, Kirpalani H, Ashcroft T, Bain H, Craft AW (1983) Lymphomatoid granulomatosis in a 10 year old boy. BMJ 286: 1313–1314PubMedCrossRefGoogle Scholar
  33. 33.
    Wadsworth DT, Siegel MJ, Day DL (1994) Wegener’s granulomatosis in children: chest radiographic manifestations. AJR 163: 901–905PubMedGoogle Scholar
  34. 34.
    Baldree LA, Gaber LW, McKay CP (1991) Anti-neutrophil cytoplasmic autoantibodies in a child with pauciimmune necrotizing and crescentic glomerulonephritis. Pediatr Nephrol 5: 296–299PubMedCrossRefGoogle Scholar
  35. 35.
    Brauner MW, Grenier P, Tijani K, Battesti JP, Valeyre D (1997) Pulmonary Langerhans cell histiocystosis: evolution of lesions on CT scans. Radiology 204: 497–502PubMedGoogle Scholar
  36. 36.
    Ha SY, Helms P, Fletcher M, Broadbent V, Pritchard J (1992) Lung involvement in Langerhans cell histiocytosis: prevalence, clinical features, and outcome. Pediatrics 89: 466469Google Scholar
  37. 37.
    Kulwiec EL, Lynch DA, Aguayo SM, Schwarz MI, King TE Jr (1992) Imaging of pulmonary histiocytosis X. Radiographics 12: 515–526PubMedGoogle Scholar
  38. 38.
    Nogee LM, deMello DE, Dehner LP, Cotten HR (1993) Brief report: deficiency of pulmonary surfactant protein B in congenital alveolar proteinosis. N Engl J Med 328: 406–410PubMedCrossRefGoogle Scholar
  39. 39.
    Hansell DM, Rubens MB, Padley SP, Wells AU (1997) Obliterative bronchiolitis: individual CT signs of small airways disease and functional correlation. Radiology 203: 721726Google Scholar
  40. 40.
    Desai SR, Hansell DM (1997) Small airways disease: expiratory computed tomography comes of age. Clin Radiol 52: 332–337PubMedCrossRefGoogle Scholar
  41. 41.
    Stern EJ, Muller NL, Swensen SJ, Hartman TE (1995) CT mosaic pattern of lung attenuation: etiologies and terminology. J Thorac Imaging 10: 294–297PubMedGoogle Scholar
  42. 42.
    Stern EJ, Swensen SJ, Hartman TE, Frank MS (1995) CT mosaic pattern of lung attenuation: distinguishing different cases. AJR 165: 813–816PubMedGoogle Scholar
  43. 43.
    Gruden JF, Webb WR, Warnock M (1994) Centrilobular opacities in the lung on high-resolution CT: diagnostic considerations and pathologic correlation. AJR 162: 569–574PubMedGoogle Scholar
  44. 44.
    Aquino SL, Gamsu G, Webb WR, Kee ST (1996) Tree-inbud pattern: frequency and significance on thin section CT. J Comput Assist Tomogr 20: 594–599PubMedCrossRefGoogle Scholar
  45. 45.
    Tanaka N, Matsumoto T, Kuramitsu T, Nakaki H, Ito K, Uchisako H, Miura G, Matsunaga N, Yamakawa K (1996) High resolution CT findings in community-acquired pneumonia. J Comput Assist Tomogr 20: 600–608PubMedCrossRefGoogle Scholar
  46. 46.
    Jamieson DH, Cremin BJ (1993) High resolution CT of the lungs in acute disseminated tuberculosis and a pediatric radiology perspective of the term “miliary”. Pediatr Radiol 23: 380–383PubMedCrossRefGoogle Scholar
  47. 47.
    Kim WS, Moon WK, Kim IO, Lee HJ, Im JG, Yeon KM, Han MC (1997) Pulmonary tuberculosis in children: evaluation with CT. AJR 168: 1005–1009PubMedGoogle Scholar
  48. 48.
    Santamaria F, Grillo G, Guidi G, Rotondo A, Raia V, de Ritis G, Sarnelli P, Caterino M, Greco L (1998) Cystic fibrosis: when should high-resolution computed tomography of the chest be obtained? Pediatrics 101: 908–913PubMedCrossRefGoogle Scholar
  49. 49.
    Nathanson I, Conboy K, Murphy S, Kuhn J (1991) Ultrafast computerized tomography of the chest in cystic fibrosis. Pediatr Pulmonol 11: 81PubMedCrossRefGoogle Scholar
  50. 50.
    Bhalla M, Turcios N, Aponte V, et al. (1991) Cystic fibrosis: scoring system with thin-section CT. Radiology 179: 783PubMedGoogle Scholar
  51. 51.
    Lynch DA, Newell JD, Tschomper BA, Cink TM, Newman LS, Bethel R (1993) Uncomplicated asthma in adults: comparison of CT appearance of the lungs in asthmatic and healthy subjects. Radiology 188: 829–833PubMedGoogle Scholar
  52. 52.
    Hansell DAM, Rubens MB, Padley SPG, Wells AU (1997) Obliterative bronchiolitis: individual CT signs of small airways disease and functional correlation. Radiology 203: 721726Google Scholar
  53. 53.
    Marti-Bonmati L, Perales FR, Catala F, et al. (1989) CT findings in Swyer-James syndrome. Radiology 172: 477PubMedGoogle Scholar
  54. 54.
    Chang AB, Masel JP, Masters B (1998) Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelae. Pediatr Radiol 28: 23–29PubMedCrossRefGoogle Scholar
  55. 55.
    Sargent MA, Cairns RA, Murdoch MJ, Nadel HR, Wensley D, Schultz KR (1995) Obstructive lung disease in children after allogeneic bone marrow transplantation: evaluation with high-resolution CT. AJR 164: 693–696PubMedGoogle Scholar
  56. 56.
    Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17: 1359–1371PubMedGoogle Scholar
  57. 57.
    Garg K, Lynch DA, Newell JD, King TE Jr (1994) Prolifer ative and constrictive bronchiolitis: classification and radio-logic features. AJR 162: 803–808PubMedGoogle Scholar
  58. 58.
    Stern EJ, Frank MS (1994) Small-airway diseases of the lungs: findings at expiratory CT. AJR 163: 37–41PubMedGoogle Scholar
  59. 59.
    Hansell DM, Wells AU, Rubens MB, Cole PJ (1994) Bronchiectasis: functional significance of areas of decreased attenuation at expiratory CT. Radiology 193: 369–374PubMedGoogle Scholar
  60. 60.
    Katzenstein ALA, Gordon LP, Oliphant M, Swender PT (1995) Chronic pneumonitis of infancy. A unique form of interstitial lung disease occurring in early childhood. Am J Surg Pathol 19: 439–447Google Scholar
  61. 61.
    Fan LL (1994) Evaluation and therapy of chronic interstitial pneumonitis in children. Curr Opin Pediatr 6: 248–254PubMedCrossRefGoogle Scholar
  62. 62.
    Muller NL, Coiby TV (1997) Idiopathic interstitial pneumonias: high-resolution CT and histologic findings. Radiographics 17: 1016–1022PubMedGoogle Scholar
  63. 63.
    Oppenheim C, Mamou-Mani T, Sayegh N, de Blic J, Scheinmann P, Lallemand D (1994) Bronchopulmonary dysplasia: value of CT in identifying pulmonary sequelae. AJR 163: 169–172PubMedGoogle Scholar
  64. 64.
    Spencer DA, Alton HM, Raafat F, Weller PH (1996) Combined percutaneous lung biopsy and high-resolution computed tomography in the diagnosis and management of lung disease in children. Pediatr Pulmonol 22: 111–116PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1999

Authors and Affiliations

  • J. P. Kuhn
    • 1
    • 2
  1. 1.Department of RadiologyChildren’s Hospital of BuffaloBuffaloUSA
  2. 2.School of Medicine and Biomedical SciencesState University of New York at BuffaloBuffaloUSA

Personalised recommendations