Imaging

Cryptogenic Organizing Pneumonia

Preliminary Diagnosis: Cryptogenic Organizing Pneumonia

I. What imaging technique is first-line for this diagnosis?

Chest X-ray, PA, and lateral view.

II. Describe the advantages and disadvantages of this technique for diagnosing cryptogenic organizing pneumonia.

Advantages

  • Inexpensive.

  • Fast imaging modality.

  • Exposes patients to minimal ionizing radiation.

  • Highly portable.

Disadvantages

Less sensitive and specific in detailing any primary parenchymal and/or pleural process or any secondary complication compared to companion cross sectional imaging.

III. What are the contraindications for the first-line imaging technique?

No specific contraindications to plain radiography exist.

IV. What alternative imaging techniques are available?

CT of the chest with IV contrast and/or high resolution CT of the chest.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing cryptogenic organizing pneumonia.

Advantages

  • More sensitive and specific in detailing a primary parenchymal or pleural abnormality and in detecting and characterizing any secondary complication than plain radiographs.

  • May help guide treatment.

  • High resolution CT imaging offers exquisite detail of the underlying brain parenchyma, surrounding vasculature, and adjacent mediastinal structures.

Disadvantages

  • Exposes patients to larger amounts of ionizing radiation.

  • More expensive and less portable compared to plain radiography.

VI. What are the contraindications for the alternative imaging techniques?

May be contraindicated in pregnant patients.

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