Is It possible to recognize pulmonary infarction on multisection CT images?

Area of Science:

• Radiology
• Pulmonary Medicine
• Diagnostic Imaging

Background:

• Pulmonary infarction diagnosis can be challenging.
• Multidetector computed tomography (CT) is crucial for evaluating peripheral pulmonary consolidations.
• Differentiating pulmonary infarction from other causes requires accurate imaging findings.

Purpose of the Study:

• To assess the sensitivity and specificity of four CT findings for distinguishing pulmonary infarction.
• To evaluate the diagnostic value of triangular shape, vessel sign, central lucencies, and air bronchograms.
• To compare these findings against clinical and other CT data.

Main Methods:

• Retrospective analysis of 150 peripheral pulmonary consolidations (50 pulmonary infarctions, 100 other causes).
• Three radiologists independently assessed CT images for triangular shape, vessel sign, central lucencies, and air bronchograms.
• Interobserver agreement, frequency, sensitivity, specificity, and positive likelihood ratio (LR) were calculated.

Main Results:

• Central lucencies were significantly more frequent in pulmonary infarctions (46%) than other consolidations (2%, P<.001) with a positive LR of 23.0.
• Air bronchograms were less frequent in pulmonary infarctions (8%) compared to other causes (40%, P=.003).
• Central lucencies demonstrated 98% specificity and 46% sensitivity for pulmonary infarction.

Conclusions:

• Central lucencies are a strong indicator of pulmonary infarction.
• The presence of central lucencies on CT scans is highly suggestive of pulmonary infarction.
• This finding aids in the differential diagnosis of peripheral pulmonary consolidations.