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Lung India Official publication of Indian Chest Society  
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REVIEW ARTICLE
Year : 2013  |  Volume : 30  |  Issue : 4  |  Page : 327-334

A systematic approach to interpretation of heterogeneous lung attenuation on computed tomography of the chest


1 Teleradiology Solutions, Delhi, India
2 Respiratory Disease Biology Unit, CSIR Institute of Genomics and Integrative Biology, Delhi, India
3 Department of Physiology, Vallabhbhai Patel Chest Institute, Delhi, India
4 Teleradiology Solutions, New Haven, CT, USA

Correspondence Address:
Anjali Agrawal
Teleradiology Solutions, 12-B Sriram Road, Civil Lines, Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-2113.120610

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Computed tomography (CT) chest is widely used as an adjunct to clinical examination and pulmonary function tests in the evaluation of unexplained dyspnoea. In such patients, heterogeneous lung attenuation is a common finding on CT. Heterogeneous lungs can be caused by varying regional aeration, varying regional perfusion, and ground glass opacities (GGO) representing airspace or interstitial pathology. It does not serve the referring clinicians or the patients well if the radiology report simply mentions the heterogeneity of the lungs without due analysis of the cause of heterogeneity and a meaningful differential diagnosis. Therefore, it is imperative for the radiologist and the treating pulmonologist to have an in-depth understanding of the pathogenesis of pulmonary heterogeneity. This, in conjunction with clinical data, can narrow the differential diagnosis or, at times, lead to specific diagnoses. The purpose of this review is to familiarize readers with the CT representation of heterogeneities in aeration and perfusion of the lung, relate patterns of GGO to underlying pathology, and provide illustrative case studies highlighting the radiological approach to heterogeneous lungs.


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