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(Chest. 1997;111:989-995.)
© 1997 American College of Chest Physicians

Pulmonary Alveolar Proteinosis

High-Resolution CT, Chest Radiographic, and Functional Correlations

Ki-Nam Lee MD1; David L. Levin MD, PhD2; W. Richard Webb MD3; DeRong Chen MD4; Maria L. Storto MD5; and Jeffrey A. Golden MD6

1 From the Department of Radiology, University of California, San Francisco; the Department of Radiology, College of Medicine, Dong-A University, Pusan, Korea
2 From the Department of Radiology, University of California, San Francisco; the Department of Radiology, Beth Israel Hospital, Boston
3 From the Department of Radiology, University of California, San Francisco
4 From the Department of Radiology, University of California, San Francisco; the Department of Radiology, Beijing (China) Hospital
5 From the Department of Radiology, University of California, San Francisco; the Ist. di Scienze Radiologiche, Osp. "SS. Annunziata", Chieti, Italy
6 From the Department of Internal Medicine, University of California, San Francisco

Study objective: To determine whether a correlation exists between pulmonary function and both frontal chest radiographs and high-resolution chest CT findings in patients with pulmonary alveolar proteinosis (PAP).

Design: Retrospective review of radiographic and clinical data.

Setting: Tertiary referral hospital.

Patients: Seven patients with PAP were studied on 25 occasions using high-resolution chest CT (n=21), frontal chest radiographs (n=19), and pulmonary function tests (PFTs) (n=25).

Measurements and results: Visual estimates of the extent, degree, and overall severity of parenchymal abnormalities were determined for plain radiographs and high-resolution chest CT, and were correlated with PFTs. With high-resolution CT, the extent and severity of ground-glass opacity correlated significantly with the presence of a restrictive ventilatory defect, reduced diffusing capacity, and hypoxemia. Chest radiographic findings also correlated significantly with restrictive ventilatory defect, diffusing capacity, and hypoxemia.

Conclusion: In patients with PAP, although high-resolution CT correlates more closely with pulmonary function, plain radiographs should be sufficient for follow-up.

Key Words: alveolar proteinosis • computed tomography • lungs • pulmonary function test

Submitted on April 18, 1996
Accepted on October 16, 2007




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