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"Crazy paving appearance" on high resolution CT in various diseases
S Murayama1, J Murakami, H Yabuuchi
1Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Journal of Computer Assisted Tomography
|October 19, 1999
Summary
Crazy-paving appearance (CPA) on high-resolution CT (HRCT) can stem from diverse conditions. Recognizing CPA on HRCT requires clinical context for accurate disease identification.
Area of Science:
- Radiology
- Pulmonary Medicine
- Pathology
Background:
- Crazy-paving appearance (CPA) is a specific pattern observed on high-resolution computed tomography (HRCT) of the lungs.
- This pattern involves the superposition of ground-glass opacity with interlobular septal and intralobular interstitial thickening.
- Understanding the differential diagnoses for CPA is crucial for patient management.
Purpose of the Study:
- To illustrate the wide spectrum of underlying pathologies that can manifest as CPA on HRCT.
- To highlight the importance of integrating HRCT findings with clinical information.
Main Methods:
- Prospective search for cases exhibiting CPA on HRCT over a 29-month period.
- Detailed analysis of identified HRCT scans showing CPA.
- Correlation of imaging findings with confirmed diagnoses.
Main Results:
- Ten cases of CPA were identified on HRCT.
- The identified etiologies included Pneumocystis carinii pneumonia (4 cases), alveolar proteinosis (1 case), usual interstitial pneumonia (1 case), pulmonary hemorrhage (1 case), acute radiation pneumonitis (1 case), adult respiratory distress syndrome (1 case), and drug-induced pneumonitis (1 case).
Conclusions:
- CPA on HRCT is not specific to a single disease entity and can be caused by numerous conditions.
- Clinical correlation is essential for differentiating the various causes of CPA observed on HRCT.