Hyperoxia-induced Diffuse Alveolar Damage in Pigs: Correlation between Thin-Section CT and Histopathologic Findings1
Kazuya Ichikado, MD,
Moritaka Suga, MD,
Yasuhiro Gushima, MD,
Takeshi Johkoh, MD,
Kazuhiro Iyonaga, MD,
Toshimi Yokoyama, MD,
Osamu Honda, MD,
Yoshihisa Shigeto, MD,
Seiji Tomiguchi, MD,
Mutsumasa Takahashi, MD,
Harumi Itoh, MD,
Junpei Ikezoe, MD,
Nestor L. Müller, MD, PhD and
Masayuki Ando, MD, PhD
1 From the First Dept of Internal Medicine (K. Ichikado, M.S., Y.G., K. Iyonaga, M.A.) and Dept of Radiology (T.Y., S.T., M.T.), Kumamoto Univ School of Medicine, 1-1-1 Honjo, Kumamoto, 860-0811, Japan; Depts of Radiology (T.J., O.H.) and Internal Medicine (Y.S.), Osaka Univ Medical School, Japan; Dept of Radiology, Kyoto Univ Hosp Shogoin, Japan (H.I.); Dept of Radiology, Ehime Univ Medical School, Japan (J.I.); and Dept of Radiology, Vancouver Hosp and Health Sciences Centre and Univ of British Columbia, Canada (N.L.M.). From the 1997 RSNA scientific assembly. Received Jul 16, 1999; revision requested Aug 26; revision received Oct 14; accepted Oct 26. Address correspondence to K. Ichikado (e-mail: ichikado@kaiju.medic.kumamoto-u.ac.jp).
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Figure 1a. (a) Transverse thin-section CT scan of the left lower lobe of a of pig subjected to hyperoxia for 48 hours shows no abnormalities. (b) Histologic lung specimen that corresponds to an area of normal attenuation in a shows patchy infiltration (arrows). (Hematoxylin-eosin stain; original magnification, x5.) (c) Another histologic specimen from the lung in a shows mild thickening of alveolar septa due to mononuclear infiltrate and edema (arrows), which is a feature of the early exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 1b. (a) Transverse thin-section CT scan of the left lower lobe of a of pig subjected to hyperoxia for 48 hours shows no abnormalities. (b) Histologic lung specimen that corresponds to an area of normal attenuation in a shows patchy infiltration (arrows). (Hematoxylin-eosin stain; original magnification, x5.) (c) Another histologic specimen from the lung in a shows mild thickening of alveolar septa due to mononuclear infiltrate and edema (arrows), which is a feature of the early exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 1c. (a) Transverse thin-section CT scan of the left lower lobe of a of pig subjected to hyperoxia for 48 hours shows no abnormalities. (b) Histologic lung specimen that corresponds to an area of normal attenuation in a shows patchy infiltration (arrows). (Hematoxylin-eosin stain; original magnification, x5.) (c) Another histologic specimen from the lung in a shows mild thickening of alveolar septa due to mononuclear infiltrate and edema (arrows), which is a feature of the early exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 2a. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 72 hours shows a mosaic pattern of lung attenuation that consists of spared areas (arrowheads) and areas of ground-glass opacity with thickened interlobular septa (arrows). The spared areas correspond to the early exudative histologic phase of DAD. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area of ground-glass opacity in the left lung in a. Note that the secondary pulmonary lobule is diffusely involved with thickened interlobular septa (arrows). (c) Histologic specimen that corresponds to the boundary between the spared areas (right) and the areas of ground-glass opacity (left) in a shows a thickened interlobular septum due to edema (arrow) that demarcates the involved from the less involved lobules. (Hematoxylin-eosin stain; original magnification, x5.) (d) Histologic specimen that corresponds to the areas of ground-glass opacity in a shows intraalveolar fibrinous exudates and hyaline membranes (arrows), which are features of the exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 2b. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 72 hours shows a mosaic pattern of lung attenuation that consists of spared areas (arrowheads) and areas of ground-glass opacity with thickened interlobular septa (arrows). The spared areas correspond to the early exudative histologic phase of DAD. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area of ground-glass opacity in the left lung in a. Note that the secondary pulmonary lobule is diffusely involved with thickened interlobular septa (arrows). (c) Histologic specimen that corresponds to the boundary between the spared areas (right) and the areas of ground-glass opacity (left) in a shows a thickened interlobular septum due to edema (arrow) that demarcates the involved from the less involved lobules. (Hematoxylin-eosin stain; original magnification, x5.) (d) Histologic specimen that corresponds to the areas of ground-glass opacity in a shows intraalveolar fibrinous exudates and hyaline membranes (arrows), which are features of the exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 2c. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 72 hours shows a mosaic pattern of lung attenuation that consists of spared areas (arrowheads) and areas of ground-glass opacity with thickened interlobular septa (arrows). The spared areas correspond to the early exudative histologic phase of DAD. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area of ground-glass opacity in the left lung in a. Note that the secondary pulmonary lobule is diffusely involved with thickened interlobular septa (arrows). (c) Histologic specimen that corresponds to the boundary between the spared areas (right) and the areas of ground-glass opacity (left) in a shows a thickened interlobular septum due to edema (arrow) that demarcates the involved from the less involved lobules. (Hematoxylin-eosin stain; original magnification, x5.) (d) Histologic specimen that corresponds to the areas of ground-glass opacity in a shows intraalveolar fibrinous exudates and hyaline membranes (arrows), which are features of the exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 2d. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 72 hours shows a mosaic pattern of lung attenuation that consists of spared areas (arrowheads) and areas of ground-glass opacity with thickened interlobular septa (arrows). The spared areas correspond to the early exudative histologic phase of DAD. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area of ground-glass opacity in the left lung in a. Note that the secondary pulmonary lobule is diffusely involved with thickened interlobular septa (arrows). (c) Histologic specimen that corresponds to the boundary between the spared areas (right) and the areas of ground-glass opacity (left) in a shows a thickened interlobular septum due to edema (arrow) that demarcates the involved from the less involved lobules. (Hematoxylin-eosin stain; original magnification, x5.) (d) Histologic specimen that corresponds to the areas of ground-glass opacity in a shows intraalveolar fibrinous exudates and hyaline membranes (arrows), which are features of the exudative phase of DAD. (Hematoxylin-eosin stain; original magnification, x100.)
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Figure 3a. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 96 hours shows heterogeneous attenuation (arrows), ground-glass opacity, and spared areas. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area in the left lung in a that shows the boundary between the area of heterogeneous attenuation and the spared areas. Note that the hemorrhagic spots (dark areas) correspond to the dots of high attenuation within the area of heterogeneous attenuation in a.
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Figure 3b. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 96 hours shows heterogeneous attenuation (arrows), ground-glass opacity, and spared areas. (b) Stereomicroscopic view of an area of the right lung that corresponds to the area in the left lung in a that shows the boundary between the area of heterogeneous attenuation and the spared areas. Note that the hemorrhagic spots (dark areas) correspond to the dots of high attenuation within the area of heterogeneous attenuation in a.
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Figure 4a. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 120 hours shows diffuse dilatation of bronchioles (arrows) within areas of increased attenuation. (b) Stereomicroscopic view of the right lung that corresponds to the same level in the left lung in a shows diffuse bronchiolectasis (arrows) within secondary pulmonary lobules and septal thickening (arrowheads). (c) Histologic specimen that corresponds to the area of increased attenuation with traction bronchiolectasis in a shows type II pneumocyte hyperplasia and interstitial fibroblastic proliferation (arrow) associated with microatelectasis (arrowheads), which are features of the early proliferative phase of DAD. (Hematoxylin-eosin stain; original magnification, x40.)
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Figure 4b. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 120 hours shows diffuse dilatation of bronchioles (arrows) within areas of increased attenuation. (b) Stereomicroscopic view of the right lung that corresponds to the same level in the left lung in a shows diffuse bronchiolectasis (arrows) within secondary pulmonary lobules and septal thickening (arrowheads). (c) Histologic specimen that corresponds to the area of increased attenuation with traction bronchiolectasis in a shows type II pneumocyte hyperplasia and interstitial fibroblastic proliferation (arrow) associated with microatelectasis (arrowheads), which are features of the early proliferative phase of DAD. (Hematoxylin-eosin stain; original magnification, x40.)
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Figure 4c. (a) Transverse thin-section CT scan of the left lower lobe of a pig subjected to hyperoxia for 120 hours shows diffuse dilatation of bronchioles (arrows) within areas of increased attenuation. (b) Stereomicroscopic view of the right lung that corresponds to the same level in the left lung in a shows diffuse bronchiolectasis (arrows) within secondary pulmonary lobules and septal thickening (arrowheads). (c) Histologic specimen that corresponds to the area of increased attenuation with traction bronchiolectasis in a shows type II pneumocyte hyperplasia and interstitial fibroblastic proliferation (arrow) associated with microatelectasis (arrowheads), which are features of the early proliferative phase of DAD. (Hematoxylin-eosin stain; original magnification, x40.)
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Figure 5. Graph depicts the relationship between thin-section CT findings and histologic scores in the hyperoxia-induced DAD porcine model. The 14 areas of normal attenuation include 11 areas selected from the pigs subjected to hyperoxia and three areas from the control animals. There was a strong correlation between the thin-section CT findings and the histologic scores of hyperoxia-induced DAD ( = 0.86, P <.001).
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Copyright © 2000 by the Radiological Society of North America.
