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Reversed Halo Sign on High-Resolution CT of Cryptogenic Organizing Pneumonia: Diagnostic Implications

 Sang Jin Kim  ;  Kyung Soo Lee  ;  Ki Jun Sung  ;  Tae Sung Kim  ;  Kyu Ok Choe  ;  Young Cheol Yoon  ;  Young Hoon Ryu 
 American Journal of Roentgenology, Vol.180(5) : 1251-1254, 2003 
Journal Title
 American Journal of Roentgenology 
Issue Date
Adult ; Aged ; Cryptogenic Organizing Pneumonia/diagnostic imaging* ; Female ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed*
OBJECTIVE: The aim of our study was to evaluate the usefulness of the reversed halo sign on high-resolution CT in the diagnosis of cryptogenic organizing pneumonia. MATERIALS AND METHODS: Between 1996 and 2001, we saw 31 patients with biopsy-proven cryptogenic organizing pneumonia. During the same period, we also saw 30 patients with non-cryptogenic organizing pneumonia diseases, from which cryptogenic organizing pneumonia should be differentiated: Wegener's granulomatosis (n = 14), diffuse bronchioloalveolar carcinoma (n = 10), chronic eosinophilic pneumonia (n = 5), and Churg-Strauss syndrome (n = 1). Two independent observers analyzed CT findings and recorded how frequently the so-called reversed halo sign (central ground-glass opacity and surrounding air-space consolidation of crescentic and ring shape) was seen on high-resolution CT. RESULTS: The most common patterns of parenchymal abnormalities of cryptogenic organizing pneumonia were ground-glass opacity (28/31 patients, 90%) and consolidation (27/31, 87%). The ground-glass opacity pattern showed random distribution, and the consolidation pattern showed subpleural or peribronchovascular (20/27 patients, 74%) distribution with predominance in the middle or lower lung zone. The reversed CT halo sign was seen in six (19%) of 31 patients with cryptogenic organizing pneumonia and in none of the patients with the diseases that needed to be differentiated from cryptogenic organizing pneumonia on CT. CONCLUSION: The reversed halo sign, although seen only in one fifth of patients with the disease, appears relatively specific to make a diagnosis of cryptogenic organizing pneumonia on CT.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Choe, Kyu Ok(최규옥)
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