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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
Air trappingConstrictive bronchiolitisExpiratory phaseHigh-resolution computed tomographyMosaic attenuationSmall airways disease

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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.