ILD
Conditions
Brief summary
Aim of the study To determine the frequency misdiagnosis of cardiac congestion as interstitial lung disease based on initial High Resolution CT interpretation alone. To identify specific HRCT findings that are more commonly associated with misdiagnosis versus correct diagnosis of the underlying condition. To establish diagnostic criteria or HRCT patterns that distinguish cardiac congestion from interstitial lung disease
Detailed description
Observational study of 150 patients found that cardiac congestion was misdiagnosed as interstitial lung disease in 24% of cases on initial HRCT imaging alone. Echocardiography and clinical correlation were needed to make the correct diagnosis . Misdiagnosis can lead to inappropriate treatment with immunosuppressive drugs which could exacerbate right heart failure in patients who actually have cardiac congestion. Correct diagnosis is important for prognosis and management. Subtle findings like upper lobe predominance of opacities, septal lines and a mosaic attenuation pattern on HRCT favor interstitial lung disease, while diffuse ground glass with central and perihilar distribution favors cardiac congestion . Associated findings on HRCT like enlarged cardiac silhouette, pleural and pericardial effusions help suggest the diagnosis of cardiac congestion over idiopathic interstitial pneumonia . Integrating clinical data on risk factors for heart failure, echocardiography findings and follow-up imaging response to diuretic therapy can help differentiate the two conditions when HRCT is non-specific
Interventions
None listed
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients who underwent HRCT imaging of the chest for evaluation of suspected interstitial lung disease * Initial radiology report included a definitive diagnosis of interstitial lung disease patterns * Age 18+ years * No prior history of pulmonary or cardiac
Exclusion criteria
* Inconclusive or unclear initial HRCT report * Underlying diagnosis other than interstitial lung disease or cardiac congestion
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of initial HRCT interpretation | baseline | (percentage of cases initially read as interstitial lung disease that were later found to be cardiac congestion) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to correct diagnosis | baseline | Mean or median number of days/months between initial misdiagnosis on HRCT and reaching accurate diagnosis of cardiac congestion |
Contacts
Primary ContactHend saleh, MD
Backup ContactMohamed Abdalrahman, MD
Outcome results
None listed