Tomografía computada de alta resolución en el diagnóstico de la fibrosis pulmonar idiopática

Abstract

High resolution computed tomography in the diagnosis of idiopathic pulmonary fibrosis Usual interstitial pneumonia pattern (UIP) in high-resolution computed tomography (HRCT) has a high degree of correlation with the histological pattern which makes it possible to obviate in these cases the need for lung biopsy. The accuracy of a UIP diagnosis in HRCT is based on the detection of specific signs of fibrosis such as honeycomb and reticular densities with traction bronchiolectasis. The update of the 2018 Clinical Practice Guidelines of the ATS / ERS / JRS / ALAT of Idiopathic Pulmonary Fibrosis (IPF) and the Fleischner Society White Paper proposed a new way of classifying the tomographic patterns taking into account the aspects previously considered. Although the presence of honeycomb remains the main finding to characterize the UIP pattern, the distribution of interstitial reticulate and the presence of traction bronchiolectasis, in the specific clinical context, may be sufficient to make the diagnosis of idiopathic pulmonary fibrosis.