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ROENTGENOLOGIC FINDINGS OF INTERSTITIAL PNEUMONIA

The clinico-pathologic dehition of interstitial pneumonia has not been completely defined and there still remain difficulties in fully illustrating this condition. Furthermore, it is frequently confusing in diagnosing interstitial pneumonia by roentgenograms selectively, since transition from interstitial pneumonia to bronchopneumonia or their co-existence is highly possible. Its diagnosis is made by their dominant features from a clinico-roentgenologic standpoint. We have adopted the following roentgenological changes as the main criteria for interstitial pneumonia, nearly always accompanying pulmonary fibrosis, except for cases with acute inflammation. 1) Fine or somewhat gross nodulation, 2) abnormal linear shadows or reticulation, 3) exaggeration of lung markings, and 4) abnormalities of vascular shadows: irregular running course, imbalanced calibers and irregular countour. In oder to confirm these changes precisely, especially the vascular abnormalities, we use the three fold magnification plain radiography, photographic enlargement of plain film, magmihation selected bronchography and ma@cation wedged arteriography, in addition to the usual bilateral, highvoltage and contrast radiographies. As for fundamental clinico-pathologic study, we have investigated the actual minute pathologic condition of each point or reticulo-linear shadow and irregularity of vascular shadow, by means of soft ray radiography of slices of the lung in its original form and size, applying Weibel-Vidone’s method, in comparison with findings of histologic specimens. It may be needless to say that the radiographic patterns are relatively different, according to the kind of disease, such as virus pneumonia, pneumonitis due to noxious gas inhalation, radiation pneumonitis or collagen disease, but, when interstitial pneumonitis results in interstitial fibrosis, we can at least detect the abnormalities of vascular shadows, and this may be an important radiologic finding of chronic interstitial pneumonia.