How to diagnose common lung diseases using chest imaging

Abstract

Chest CT imaging plays a crucial role in diagnosing various pulmonary diseases. Despite the diverse clinical presentations, imaging patterns can be categorized into distinct groups, often identified using metaphoric radiological signs. Some signs are pathognomonic for specific diseases, while others narrow the differential diagnosis. Recognizing these imaging patterns and their diagnostic implications is essential for pulmonologists. This pictorial review presents significant chest CT scan signs and their associated pulmonary diseases, emphasizing their description in the context of increasing reliance on CT imaging. Visual memory and iconographic learning have become integral to radiological language, linking CT findings with naturalistic images or symbolic representations to enhance concept assimilation and retention. Familiarity with these signs also improves diagnostic specificity due to the strong correlation between imaging features and particular thoracic diseases. The review covers various signs, including the air bronchogram, air crescent, arcade-like, atoll, cheerios, crazy paving, comet tail, dark bronchus, doughnut, eggshell calcifications, feeding vessel, finger-in-glove, Fleischner, galaxy, ginkgo leaf, Golden S, halo, headcheese, honeycombing, interface, Monod, mosaic attenuation, Oreo cookie, polo mint, popcorn calcification, positive bronchus, railway track, scimitar, signet ring, snowstorm, sunburst, tree-in-bud, and tram track signs. The review also briefly discusses miscellaneous signs like the serpent, water lily, cervicothoracic, hilum overlay, deep sulcus, Hampton's hump, and Swiss cheese signs. Understanding these radiological signs strengthens diagnostic accuracy and contributes to improved patient outcomes in pulmonary medicine.