Idiopathic pulmonary fibrosis: progression of honeycombing at thin-section CT

• Published in: Radiology Vol. 189; no. 3; p. 687
• Main Authors: Akira, M, Sakatani, M, Ueda, E
• Format: Journal Article
• Language: English
• Published: United States 01.12.1993
• Subjects: Female; Follow-Up Studies; Humans; Lung - diagnostic imaging; Male; Methylprednisolone - therapeutic use; Middle Aged; Prednisolone - therapeutic use; Prognosis; Pulmonary Fibrosis - diagnostic imaging; Pulmonary Fibrosis - drug therapy; Pulmonary Fibrosis - epidemiology; Time Factors; Tomography, X-Ray Computed - methods
• ISSN: 0033-8419
• DOI: 10.1148/radiology.189.3.8080483

To evaluate the progression of honeycombing at computed tomography (CT) and to determine serial changes in the pattern of disease. CT scans, obtained in 29 patients with idiopathic pulmonary fibrosis who had undergone at least two serial CT examinations 1-52 months apart, were reviewed. Twelve patients had received no treatment, and 17 patients had received corticosteroids. Initial and follow-up CT scans were evaluated independently and then directly compared with each other. Twenty-six of the 29 patients showed progression of honeycombing, which was variable at CT (median, 0.4% [range, 0%-11%] per month) but not significantly different between untreated and treated patients. Areas of ground-glass attenuation on CT scans preceded and were predictive of the development of honeycombing in that location. Corticosteroid treatment reduced areas of ground-glass attenuation, but honeycombing on CT scans was irreversible. Low-dose therapy with corticosteroids does not suppress alveolitis sufficiently to prevent continued deterioration of the alveolar structures.