Imaging

Eosinophilic Pneumonia

Preliminary Diagnosis: Eosinophilic Pneumonia

I. What imaging technique is first-line for this diagnosis?

Chest radiographs (CXR) with posteroanterior (PA) and lateral projections.

II. Describe the advantages and disadvantages of this technique for diagnosing eosinophilic pneumonia.

Advantages

  • Can be diagnostic for Loffler syndrome, acute or chronic eosinophilic pneumonia, or idiopathic hypereosinophilic syndrome.

  • Less expensive than computed tomography (CT) of the chest.

  • Exposes the patient to less ionizing radiation than computed tomography (CT) of the chest.

Disadvantages

  • Findings may be non-specific.

III. What are the contraindications for the first-line imaging technique?

CXR has no significant contraindications.

IV. What alternative imaging techniques are available?

CT chest without contrast.

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing eosinophilic pneumonia.

Advantages

  • Is diagnostic and much more sensitive for the diagnosis of Loffler syndrome, acute or chronic eosinophilic pneumonia, or idiopathic hypereosinophilic syndrome than chest x-ray.

  • Can better depict the extent and patterns of eosinophilic pneumonia.

  • Can better differentiate eosinophilic pneumonia from mimics like organizing pneumonia or diffuse pulmonary hemorrhage.

Disadvantages

  • CT exposes the patient to more ionizing radiation than chest radiography.

VI. What are the contraindications for the alternative imaging techniques?

CT is contraindicated in pregnant women, especially during the first and second trimesters.

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