RESUMO
Idiopathic interstitial pneumonias comprise 8 clinicopathological entities, most of them with a chronic course and various prognosis. Idiopathic pulmonary fibrosis is the most frequent and most severe of these. Computed tomography has an important role for its diagnosis. It can identify the corresponding pathological pattern of usual interstitial pneumonia in about 50 percent of cases. It can suggest differential diagnosis in other cases, most frequently fibrosing nonspecific interstitial pneumonia and chronic hypersensitivity pneumonitis. Imaging features should be integrated to clinical and available pathologic data during multidisciplinary team meetings involving physicians with a good knowledge of interstitial diseases. Some cases may be unclassifiable, but these could later be reclassified as new data may occur or imaging features may change. Surgical lung biopsy is being less frequently performed and an emerging less invasive technique, lung cryobiopsy, is under evaluation. Pleuroparenchymal fibroelastosis is a distinct entity only recently described, with uncertain prevalence and prognosis that seems being quite often associated to another pattern of interstitial pneumonia.
Assuntos
Pneumonias Intersticiais Idiopáticas/diagnóstico , Alveolite Alérgica Extrínseca/classificação , Alveolite Alérgica Extrínseca/diagnóstico , Alveolite Alérgica Extrínseca/epidemiologia , Alveolite Alérgica Extrínseca/patologia , Biópsia , Diagnóstico Diferencial , Humanos , Pneumonias Intersticiais Idiopáticas/classificação , Pneumonias Intersticiais Idiopáticas/epidemiologia , Pneumonias Intersticiais Idiopáticas/patologia , Fibrose Pulmonar Idiopática/diagnóstico , Fibrose Pulmonar Idiopática/epidemiologia , Fibrose Pulmonar Idiopática/patologia , Doenças Pulmonares Intersticiais/diagnóstico , Doenças Pulmonares Intersticiais/epidemiologia , Doenças Pulmonares Intersticiais/patologia , Valor Preditivo dos Testes , PrognósticoRESUMO
Lung cancer is the leading cause of cancer death worldwide. Prognosis and treatment outcomes are known to be related to the disease stage at the time of diagnosis. Therefore, an accurate assessment of the extent of disease is critical to determine the most appropriate therapy. Currently available imaging modalities for diagnosis and follow-up consist of morphological and functional imaging. Morphological investigations are mainly performed with CT-scan and in some cases with MRI. In this review, we describe the contribution of MRI in lung cancer staging focusing on solid pulmonary nodule characterization and TNM staging assessment using chest and whole-body MRI examinations, detailing in each chapter current recommendations and future developments.
