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    Thoracic Imaging

    Eosinophilic Lung Diseases: Diagnostic Accuracy of Thin-Section CT in 111 Patients

    Published Online:Sep 1 2000https://doi.org/10.1148/radiology.216.3.r00se01773

    Abstract

    PURPOSE: To determine whether various eosinophilic lung diseases can be differentiated by means of thin-section computed tomography (CT).

    MATERIALS AND METHODS: Thin-section CT scans in 111 patients with eosinophilic lung diseases—40 with chronic eosinophilic pneumonia, 16 with Churg-Strauss syndrome, 16 with allergic bronchopulmonary aspergillosis (ABPA), 13 with acute eosinophilic pneumonia, 12 with simple pulmonary eosinophilia, 11 with drug-induced eosinophilic pneumonia, and three with hypereosinophilic syndrome—were assessed independently by two observers. The observers recorded the abnormalities, diagnosis, and degree of confidence in the diagnosis.

    RESULTS: The two observers made a correct first-choice diagnosis on average in 61% of readings. The correct diagnosis was made in 78% of cases of chronic eosinophilic pneumonia; 81%, acute eosinophilic pneumonia; 44%, Churg-Strauss syndrome; 84%, ABPA; 17%, simple pulmonary eosinophilia; 27%, drug-induced eosinophilic pneumonia; and 33%, hypereosinophilic syndrome. The two observers made a correct diagnosis with a high degree of confidence in 36% of readings. There was moderate agreement between the observers for the correct diagnosis (κ, 0.47) and for the correct diagnosis with a high degree of confidence (κ, 0.59).

    CONCLUSION: Although eosinophilic lung diseases often can be differentiated by means of thin-section CT, correlation between CT findings and careful clinical evaluation are required for a definitive diagnosis.

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    Article History

    Published in print: Sept 2000