The efficacy of interferon alfa (IFN-alpha) was evaluated in 127 hepatitis C virus-ribonucleic acid (HCV-RNA)-positive patients with chronic hepatitis C in relation to HCV-RNA levels and genotype. Patients were assigned to one of three groups. Patients in group A received IFN-alpha daily for 8 weeks (total dose, 336 million units [MU]); patients in group B received IFN-alpha daily for 4 weeks and then intermittently for 20 weeks (total dose, 348 MU); and patients in group C received IFN-alpha daily for 2 weeks and then intermittently for 22 weeks (total dose, 480 MU). Complete response rates in groups B and C were significantly higher than those in group A, regardless of the virus level or genotype. Complete response rates in groups B and C were similar, but in patients with a high virus level or HCV-RNA genotype II, the partial response rate in group C was significantly higher than that in group B. In conclusion, IFN-alpha was more effective after daily and then intermittent administration than after daily administration only, and a higher daily dose was necessary to be more effective in patients with high virus levels or HCV-RNA genotype II.

Adult↗

PubMedDate not supplied

Respiratory change in size of honeycombing: inspiratory and expiratory spiral volumetric CT analysis of 97 cases.

PURPOSE: The purpose of this study was twofold: to evaluate the change in size of honeycomb cysts with respiration using inspiratory-expiratory spiral volumetric CT (I-E SVCT) and to establish the pathologic basis of this change. METHOD: Ninety-seven patients, who had honeycombing associated with end-stage pulmonary fibrosis on end-inspiratory 1 to 2 mm collimation high-resolution CT (HRCT), underwent I-E SVCT (3 mm collimation, pitch 1, breath-hold time 20 s, reconstruction interval 1 mm, FOV 16-20 cm, high frequency algorithm). I-E SVCT scans were assessed on images obtained in the transverse plane and volumetric sagittal, coronal, and oblique reformations. The histologic findings were assessed in four inflated and fixed lungs that showed honeycombing at postmortem HRCT. RESULTS: In 63 patients (65%), a small percentage of the cysts did not change in size at end-expiration, while in the remaining patients, all the cysts decreased in size. Assessment of volumetric multiplanar reformations showed that cysts that decreased in size during exhalation communicated with airways and represented bronchiolectasis rather than true cysts, while the other cysts did not communicate with the airways. Similar findings were found in pathologic specimens. CONCLUSION: The majority of, but not all, honeycomb cysts seen on HRCT represent dilated bronchioles that communicate with the proximal airways and change in size with respiration.

Adult↗

PubMedDate not supplied

Comparison of high resolution CT findings of sarcoidosis, lymphoma, and lymphangitic carcinoma: is there any difference of involved interstitium?

PURPOSE: The purpose of this study was to determine distinguishing features of three diseases that are distributed along the lymphatics. METHOD: CT scans of 40 patients with lymphangitic carcinomatosis, 41 with sarcoidosis, and 44 with malignant lymphoma were retrospectively reviewed. We evaluated the degree of involvement of the interlobular septa, bronchovascular structures, subpleural interstitium, and other CT findings. RESULTS: The number of thickened interlobular septa and the extent of involvement of the subpleural interstitium in lymphangitic carcinomatosis were higher than those in sarcoidosis and malignant lymphoma (p<0.0001). Nodules of >1 cm in diameter were more often seen in malignant lymphoma (41.0%) than in the other two diseases (p < 0.001). Bilateral distribution was more common in sarcoidosis (100%) than in the others (p<0.001). CONCLUSION: The major difference among lymphangitic carcinomatosis, sarcoidosis, and malignant lymphoma is the greater involvement of the interlobular septa and subpleural interstitium in lymphangitic carcinomatosis than in either sarcoidosis or malignant lymphoma.

Adult↗

PubMedDate not supplied

Can acute interstitial pneumonia be differentiated from bronchiolitis obliterans organizing pneumonia by high-resolution CT?

PURPOSE: In the early stages, clinical and chest radiographic findings of acute interstitial pneumonia (AIP) are often similar to those of bronchiolitis obliterans organizing pneumonia (BOOP). However, patients with AIP have a poor prognosis, while those with BOOP can achieve a complete recovery after corticosteroid therapy. The objective of this study was to identify differences in high-resolution CT (HRCT) findings between the two diseases. METHODS: The study included 27 patients with AIP and 14 with BOOP who were histologically diagnosed [open-lung biopsy (n=7), autopsy (n=17), transbronchial lung biopsy (n=17)]. The frequency and distribution of various HRCT findings for each disease were retrospectively evaluated. RESULTS: Traction bronchiectasis, interlobular septal thickening, and intralobular reticular opacities were significantly more prevalent in AIP (92.6%, 85.2%, and 59.3%, respectively) than in BOOP (42.9%, 35.7%, and 14.3%, respectively) (p<0.01). Parenchymal nodules and peripheral distribution were more prevalent in BOOP (28.6% and 57.1%, respectively) than in AIP (7.4% and 14.8%, respectively) (p<0.01). Areas with ground-glass attenuation, air-space consolidation, and architectural distortion were common in both AIP and BOOP. CONCLUSION: For a differential diagnosis of AIP and BOOP, special attention should be given to the following HRCT findings: traction bronchiectasis, interlobular septal thickening, intralobular reticular opacities, parenchymal nodules, pleural effusion, and peripheral zone predominance.

Acute Disease↗

PubMedDate not supplied

Visualization of air-trapping area with expiratory CT in hypersensitivity pneumonitis.

We report a case of summer-type hypersensitivity pneumonitis that demonstrated air-trapping. In this case we used images at inspiratory and expiratory volumetric HRCT, which enabled us to obtain images of the same level at inspiratory and expiratory CT.

Alveolitis, Extrinsic Allergic↗