HRCT in prone position

Q: 68 year old male is admitted to ICU with SOB. Patient required intubation. Pulmonary service after reviewing history, exam and available data suggested High Resolution CT (HRCT) scan in prone position. In which of the pulmonary conditions, HRCT scan in prone position is preferred? 

A) Acute interstitial pneumonia 
B) Lymphocytic interstitial pneumonia 
C)  Cryptogenic organizing pneumonia
D) Asbestosis 
E)  Langerhans cell histiocytosis 




Answer: D 

Fibrosis in asbestosis  predominantly effects basal and dorsal lung parenchymal. Prone HRCT in  asbestosis better display the fixed, nongravitational changes at the lung bases. Another differentiating point between asbestosis and Interstitial Pulmonary Fibrosis (IPF) is more parenchymal bands or long scars in asbestosis than IPF. 

#pulmonary
#radiology


Reference: 

Gamsu G, Salmon CJ, Warnock ML, Blanc PD. CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods. AJR Am J Roentgenol 1995; 164:63.