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Computed tomographic scanning in sarcoidosis.

Joseph P Lynch1

  • 1Division of Pulmonary and Critical Care Medicine, University of Michigan Medical Center, Ann Arbor, Michigan 48109-0360, USA. jlynch@umich.edu

Seminars in Respiratory and Critical Care Medicine
|August 10, 2005
PubMed
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Sarcoidosis commonly affects the lungs, often presenting with bilateral hilar lymphadenopathy on chest X-rays. Computed tomography (CT) scans offer detailed imaging for diagnosis and prognosis assessment.

Area of Science:

  • Radiology
  • Pulmonology
  • Immunology

Background:

  • Sarcoidosis is a multisystem granulomatous disease with >90% pulmonary involvement.
  • Pulmonary manifestations, particularly bilateral hilar lymphadenopathy (BHL), are common radiographic findings.
  • Chest radiographs reveal abnormalities in 90-95% of sarcoidosis patients.

Purpose of the Study:

  • To review radiographic and CT features of sarcoidosis.
  • To evaluate the impact of radiographic stage on prognosis.
  • To discuss the role of CT and HRCT in diagnosis, prognosis, and differentiating fibrosis from inflammation.

Main Methods:

  • Review of radiographic and CT imaging findings in sarcoidosis.
  • Correlation of imaging findings with clinical presentation and prognosis.

Related Experiment Videos

  • Discussion of high-resolution CT (HRCT) for assessing disease activity and fibrosis.

    • Main Results:

    • Bilateral hilar lymphadenopathy (BHL) is a characteristic radiographic feature (50-80%).
    • Pulmonary parenchymal infiltrates occur in 25-50% of patients.
    • CT scans are more sensitive than radiographs for delineating thoracic structures; specific CT patterns can be pathognomonic.

    Conclusions:

    • Radiography is crucial for sarcoidosis diagnosis, with BHL being a key sign.
    • CT and HRCT are valuable for atypical cases, assessing prognosis, and differentiating active inflammation from fibrosis.
    • While not routine, CT plays a vital role in managing complex sarcoidosis cases.