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Mosaic Attenuation Pattern: A Guide to Analysis with HRCT
Gregory M Lee1, Melissa B Carroll2, Jeffrey R Galvin1
1Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, 22 South Greene Street, Baltimore, MD 21201, USA.
Radiologic Clinics of North America
|October 6, 2022
Summary
Mosaic attenuation on CT scans has many causes, affecting airways, vessels, or lung tissue. Clinical history and CT findings help diagnose these conditions, often without needing a biopsy.
Area of Science:
- Radiology
- Pulmonary Medicine
- Pathology
Background:
- Mosaic attenuation is a common finding on high-resolution computed tomography (HRCT).
- It can result from various diseases affecting small airways, pulmonary vessels, alveoli, or interstitium.
- Some conditions may involve combinations of these compartments.
Purpose of the Study:
- To review the differential diagnosis of mosaic attenuation patterns seen on HRCT.
- To highlight the role of ancillary CT findings and clinical history in diagnosis.
- To discuss the underlying pathologies leading to mosaic attenuation.
Main Methods:
- Review of literature on mosaic attenuation patterns in pulmonary diseases.
- Analysis of HRCT findings associated with small airway diseases, vascular pathologies, and interstitial lung diseases.
- Correlation of imaging findings with clinical presentations.
Main Results:
- Small airways disease can manifest as mosaic attenuation due to cellular or constrictive bronchiolitis and fibrosis.
- Ground-glass opacity, from acute or chronic causes, can also lead to mosaic patterns.
- Vascular causes include chronic thromboembolic pulmonary hypertension and other pulmonary arterial hypertension forms.
Conclusions:
- Mosaic attenuation on HRCT is a complex pattern with diverse etiologies.
- Integrating ancillary CT findings with clinical history is crucial for narrowing the differential diagnosis.
- Invasive procedures like biopsy are infrequently necessary for definitive diagnosis.
