Bronchiolitis obliterans with organizing pneumonia versus chronic eosinophilic pneumonia: high-resolution CT findings in 81 patients

AJR Am J Roentgenol. 2001 Apr;176(4):1053-8. doi: 10.2214/ajr.176.4.1761053.


Objective: The objective of this research was to compare high-resolution CT findings of bronchiolitis obliterans with organizing pneumonia (BOOP) with those of chronic eosinophilic pneumonia (CEP) and to determine whether high-resolution CT can differentiate the two.

Materials and methods: We retrospectively reviewed high-resolution CT scans of 38 patients with BOOP and 43 patients with CEP. Without knowledge of the diagnosis, two radiologists evaluated the frequency and distribution of high-resolution CT findings in both groups of patients and made a diagnosis using a three-point scale of confidence.

Results: Nodules, nonseptal linear or reticular opacities, and bronchial dilatation were significantly more common in BOOP than in CEP (31.6% vs. 4.7%, p < 0.005; 44.7% vs. 9.3%, p < 0.001; and 57.9% vs. 25.6%, p < 0.005, respectively). Septal line thickening was more frequent in CEP than in BOOP (72.1% vs. 39.5%, p < 0.005). Peribronchial distribution of consolidation was more frequent in BOOP than in CEP (28.9% vs. 9.3%, p < 0.05). A correct diagnosis was made in 69.7% of cases, and the diagnostician was confident in 21.7%. Interobserver agreement was good (kappa = 0.6).

Conclusion: Although several of the high-resolution CT findings of BOOP and CEP are different, these diseases are differentiated with confidence in only a small percentage of cases.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cryptogenic Organizing Pneumonia / diagnostic imaging*
  • Diagnosis, Differential
  • Female
  • Humans
  • Image Enhancement*
  • Male
  • Middle Aged
  • Pulmonary Eosinophilia / diagnostic imaging*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed*