Subpleural Bandlike Ground-glass Opacity In Thoracic CT:Differential Diagnosis Role In Paraquat Poisoning Pneumonia

Objective:To explore the differential diagnosis role of subpleural bandlike ground-glass opacity in thoracic CT of paraquat poisoning pneumonia patients.Methods:A retrospective study was taken on the hospital patients CT database from March 2013 through March 2015.The patients with paraquat poisoning pneumonia,interstitial pneumonia and pulmonary alveolar proteinosis(PAP)were enrolled and their radiological characteristics of thoracic CT were analysed.Results:A total of 698 newly diagnosed interstitial pneumonia patients were finally enrolled in this study,in which 392 of them(56.2%)presented with ground-glass opacity in thoracic CT.Otherwise,a total of 38 newly diagnosed PAP patients and 14 paraquat poisoning patients were enrolled and GGO presented in thoracic CT was in 100%and 42.9%of them respectively.Subpleural bandlike GGO was mostly commonly found in 83.3%of paraquat poisoning pneumonia patients with GGO in thoracic CT,followed by 18.4%of PAP patiens and 5.6%of interstitial pneumonia patients with GGO in thoracic CT,all significantly lower than in paraquat poisoning pneumonia patients(p<0.05).GGO associated with crazy paving pattern in thoracic CT was mostly commonly found in 94.7%of PAP patients,followed by 0.5%of interstitial pneumonia patients and none of paraquat poisoning pneumonia patients.All the PAP patients with subpleural bandlike GGO were found associated with crazy paving pattern,while none of such association was found in interstitial pneumonia and paraquat poisoning pnuemonia patients.GGO coexisting with honeycombing and subpleural line were found in 22.7%and 11.2%of interstitial pneumonia patients respectively,and none of such association was found in PAP and paraquat poisoning pneumonia patients.Conclusion:Subpleural bandlike GGO was mostly commonly found in paraquat poisoning pneumonia patients and rarely in PAP and interstitial pneumonia patients.Combined with crazy paving pattern and subpleural line,subpleural bandlike GGO may play a key role in the diagnosis of paraquat poisoning pneumonia patients.