[Invasive pulmonary aspergillosis--imaging and invasive potential of diagnosis]

Abstract

The increasing incidence of invasive pulmonary aspergillosis (IPA), especially in haemato-oncological patients, has led to recent extension and refinement of diagnostic procedures, in particular imaging examinations. From a diagnostic point of view, chest radiography is not beneficial in most IPA cases. Today, the highest diagnostic value is achieved by CT, with an apparent correlation between CT scans and pathological-anatomical findings. A usual CT finding seen in bronchoinvasive aspergillosis is a tree-in-bud pattern. Angioinvasive aspergillosis is typically characterized by initial condensation surrounded by a halo sign--an area of opacity--and, later, by an air-crescent sign--a cavitating lesion. Although the morphology of CT findings is not entirely specific, together with the clinical condition and other assessment methods, these are essential for diagnosis. In rare cases, CT angiography is indicated to clarify the CT findings. If the diagnosis still remains unclear, biopsy examination should be considered, bearing in mind possible complications.