Multiple lung parenchymal abnormalities: Don't panic, let's be pragmatic! The 6 question rule - a checklist strategy

Area of Science:

• Radiology
• Pulmonary Medicine
• Diagnostic Imaging

Background:

• High-resolution computed tomography (HRCT) reveals complex lung parenchymal abnormalities.
• Differentiating etiologies such as interstitial lung disease, bronchial issues, cardiovascular problems, or alveolar filling is diagnostically challenging.
• Concomitant diseases can further complicate HRCT interpretation.

Purpose of the Study:

• To present a systematic, pathophysiological reasoning approach for analyzing multiple lung parenchymal abnormalities on HRCT.
• To provide a logical checklist to aid non-specialist radiologists in diagnosis.
• To introduce the FIBROVAKIM mnemonic for summarizing diagnostic strategy.

Main Methods:

• Development of a systematic checklist based on pathophysiological reasoning.
• Application of the FIBROVAKIM mnemonic (fibrosis-bronchi-vascular-cancer-infection-medication) to categorize abnormalities.
• Focus on common diagnoses and treatable emergencies identifiable by non-specialist radiologists.

Main Results:

• The systematic approach provides a structured method for HRCT analysis.
• The FIBROVAKIM mnemonic offers an easy-to-apply strategy for recalling diagnostic categories.
• This method aids in identifying frequent diagnoses and critical emergencies.

Conclusions:

• A systematic, checklist-based approach improves the analysis of complex HRCT findings.
• The FIBROVAKIM mnemonic simplifies the diagnostic strategy for lung parenchymal abnormalities.
• This approach enhances diagnostic capabilities for non-specialist radiologists and facilitates further learning.