The Significance of Subpleural Sparing in CT Chest: A State-of-the-Art Review.
Am J Med Sci
; 361(4): 427-435, 2021 04.
Article
in English
| MEDLINE | ID: covidwho-1014310
ABSTRACT
The subpleural sparing pattern is a common finding on computed tomography (CT) of the lungs. It comprises of pulmonary opacities sparing the lung peripheries, typically 1cm and less from the pleural surface. This finding has a variety of causes, including idiopathic, inflammatory, infectious, inhalational, cardiac, traumatic, and bleeding disorders. Specific disorders that can cause subpleural sparing patterns include nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), pulmonary alveolar proteinosis (PAP), diffuse alveolar hemorrhage (DAH), vaping-associated lung injury (VALI), cracked lung, pulmonary edema, pneumocystis jirovecii pneumonia (PJP), pulmonary contusion, and more recently, Coronavirus disease 2019 (COVID-19) pneumonia. Knowledge of the many etiologies of this pattern can be useful in preventing diagnostic errors. In addition, although the etiology of subpleural sparing pattern is frequently indistinguishable during an initial radiologic evaluation, the differences in location of opacities in the lungs, as well as the presence of additional radiologic findings, patient history, and clinical presentation, can often be useful to suggest the appropriate diagnosis. We did a comprehensive search on Pubmed and Google Scholar database using keywords of "subpleural sparing," "peripheral sparing," "sparing of peripheries," "CT chest," "chest imaging," and "pulmonary disease." This review aims to describe the primary differential diagnosis of subpleural sparing pattern seen on chest imaging with a strong emphasis on clinical and radiographic findings. We also discuss the pathogenesis and essential clues that are crucial to narrow the differential diagnosis.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pleura
/
Radiography, Thoracic
/
Tomography, X-Ray Computed
Type of study:
Diagnostic study
/
Etiology study
/
Experimental Studies
/
Prognostic study
/
Reviews
Limits:
Humans
Language:
English
Journal:
Am J Med Sci
Year:
2021
Document Type:
Article
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