Computed Tomography in the Diagnosis of Various Forms of Amiodarone-Induced Pulmonary Toxicity

Abstract

Purpose: To determine computed tomography subtypes of amiodarone-induced pulmonary toxicity (AIPT). 
 Material and methods: We included 214 CT exams of 110 patients with history of amiodarone use. AIPT was confirmed in 90 cases. In 81 % of patients we repeat CT exam 2–5 times, observation period till 1 month to 10 years. The mean age of patients was 71 years (21 females, 69 – males). In 52 % of patients lung scintigraphy was done. We included functional lung test, spirometry, heart ultrasound in diagnostic plan.
 Results: Only in 3 % of cases we detected acute form of AIPT. In 68 % of patients subacute form was revealed, in that cases we indentified different patterns of lung defeat, which mimic oncology disease, different types of interstitial pneumonias, small vessel pulmonary embolism. In other cases chronic form AIPT was suspected. Unilateral changes and craniocaudal gradient were not pathognomic for AIPT. We did not identify consolidation zones and nodules. Honeycombing was not a typical feature of chronic form of AIPT. Appearance of ground-glass opacity pattern was feature of lung toxicity exaxerbation.
 Conclusion: AIPT diagnose of exclusion because of it’s multiple radiological subtypes. There are no specific histological or cytological markers of the disease. Only CT could identify signs of active process and differentiate different subtypes of AIPT.