HRCT findings of pulmonary complications in non-AIDS immunocompromised patients: are they useful in differential diagnosis?

PURPOSE: This study was designed to evaluate the diagnostic value of characteristic HRCT findings in the differential diagnosis of acute pulmonary complications (APCs) in immunocompromised patients and to investigate how to improve diagnostic accuracy.

MATERIALS AND

METHODS

We reviewed the chest CT images of 103 consecutive immunocompromised non-AIDS patients with APCs. The presence, extent, and anatomical distribution of the CT findings were assessed by two radiologists. The sensitivity and positive predictive value (PPV) of each criterion determined by the combination of CT findings that were characteristic in previous studies were calculated.

RESULTS

The average sensitivity of each criterion was 0.50 in the total cases. There were many false positives, and the PPVs of some criteria were low. Among the significantly less frequent CT findings, the frequency of bronchovascular bundle thickening was 0% in cytomegaloviral pneumonia (CMV P). The absence of this finding improved the diagnostic accuracy of CMV P.

CONCLUSION

Because the combination of only characteristic HRCT findings in each disease was of relatively limited value in making a diagnosis, infrequent findings should be also added to the CT criteria to improve accuracy.