Eosinophilic lung diseases: diagnostic accuracy of thin-section CT in 111 patients.
OBJECTIVE
To determine whether various eosinophilic lung diseases can be differentiated by means of thin-section computed tomography (CT).


METHODS
Thin-section CT scans in 111 patients with eosinophilic lung diseases-40 with chronic eosinophilic pneumonia, 16 with Churg-Strauss syndrome, 16 with allergic bronchopulmonary aspergillosis (ABPA), 13 with acute eosinophilic pneumonia, 12 with simple pulmonary eosinophilia, 11 with drug-induced eosinophilic pneumonia, and three with hypereosinophilic syndrome-were assessed independently by two observers. The observers recorded the abnormalities, diagnosis, and degree of confidence in the diagnosis.


RESULTS
The two observers made a correct first-choice diagnosis on average in 61% of readings. The correct diagnosis was made in 78% of cases of chronic eosinophilic pneumonia; 81%, acute eosinophilic pneumonia; 44%, Churg-Strauss syndrome; 84%, ABPA; 17%, simple pulmonary eosinophilia; 27%, drug-induced eosinophilic pneumonia; and 33%, hypereosinophilic syndrome. The two observers made a correct diagnosis with a high degree of confidence in 36% of readings. There was moderate agreement between the observers for the correct diagnosis (kappa, 0.47) and for the correct diagnosis with a high degree of confidence (kappa, 0.59).


CONCLUSIONS
Although eosinophilic lung diseases often can be differentiated by means of thin-section CT, correlation between CT findings and careful clinical evaluation are required for a definitive diagnosis.
Johkoh
T
T
Dept of Radiology, Osaka Univ Medical School, Suita, Japan. johkoh@radiol.med.osaka-u.ac.jp
Müller
N L
NL
Akira
M
M
Ichikado
K
K
Suga
M
M
Ando
M
M
Yoshinaga
T
T
Kiyama
T
T
Mihara
N
N
Honda
O
O
Tomiyama
N
N
Nakamura
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011657:Pulmonary Eosinophilia / Q000000981:diagnostic imaging* / Q000209:etiology; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed