CT SCAN – HRCT CHEST RADIOLOGY REPORT

HRCT CHEST REPORT

Clinical History:
The patient presented with  CKD, HTN AND SOB.  Further details of the clinical history, including smoking history, prior infections, or underlying comorbidities, are not provided.

Technique:
The study was performed using high-resolution computed tomography (HRCT) of the chest. Helical sections were acquired from the lung apices to the domes of the diaphragm without the administration of intravenous contrast medium.

FINDINGS:
The HRCT chest reveals the following findings:

1. Parenchymal Changes:
   1. Paraseptal Emphysema: Paraseptal emphysematous changes are noted in both upper lobes, accompanied by mild hyperinflation. These findings are consistent with chronic obstructive pulmonary disease (COPD).
   1. Patchy Consolidations: Patchy areas of consolidation are observed in both lower lobes and the perihilar regions, surrounded by ground-glass haziness. These changes may represent post-infective sequelae or an active infective/inflammatory process.
   1. No Honeycombing: There is no evidence of honeycombing, which rules out advanced fibrotic lung disease such as usual interstitial pneumonia (UIP).
2. Pleural Changes:
   1. Basal Pleural Effusions: Mild bilateral basal pleural effusions are seen, with associated underlying basal atelectatic changes. Mild pleural thickening is also noted, which may be secondary to chronic inflammation or prior infection.
3. Airways and Mediastinum:
   1. The trachea and major bronchi appear normal in caliber and morphology, with no evidence of obstruction or structural abnormality.
   1. Few subcentimetric mediastinal lymph nodes are seen in the pre/paratracheal region. These nodes are nonspecific and may be reactive in nature.
4. Cardiovascular Structures:
   1. The heart size appears normal, and no pericardial effusion is observed. The major vascular structures, including the aorta and pulmonary arteries, are unremarkable.
5. Other Findings:
   1. The esophagus and chest wall appear normal, with no evidence of structural abnormalities or pathological lesions.

IMPRESSION:
The HRCT chest findings are consistent with:

1. Chronic Obstructive Pulmonary Disease (COPD): Paraseptal emphysematous changes and mild hyperinflation in both upper lobes are indicative of COPD.
2. Bilateral Mild Basal Pleural Effusions: These effusions, along with underlying atelectatic changes and mild pleural thickening, may be related to chronic inflammation or prior infection.
3. Patchy Consolidations with Ground-Glass Haziness: The consolidations in both lower lobes and perihilar regions, surrounded by ground-glass opacities, are suggestive of post-infective sequelae. However, an active infective or inflammatory process cannot be entirely ruled out and requires clinical correlation.

Differential Diagnosis:

1. Post-infective sequelae (e.g., organizing pneumonia).
2. Active infection (e.g., bacterial or viral pneumonia).
3. Chronic inflammatory or fibrotic lung disease (less likely given the absence of honeycombing).

Recommendations:

1. Clinical Correlation
2. Consider a follow-up HRCT chest after 6-8 weeks to assess the resolution of the consolidations and pleural effusions, particularly if an active infection is suspected.
3. Additional Investigations:
   1. Pulmonary function tests (PFTs) to assess the severity of COPD.
   1. Echocardiography if cardiac involvement or secondary pulmonary hypertension is suspected.

Conclusion:
The HRCT chest findings are consistent with COPD, bilateral mild basal pleural effusions, and patchy consolidations with ground-glass haziness, likely representing post-infective sequelae. Clinical correlation and further evaluation are recommended to confirm the diagnosis and guide appropriate management.

~Axrix Teleradiology
note: this report based on scan