Pulmonary sarcoidosis: morphologic associations of airflow obstruction at thin-section CT

Radiology. 1998 Dec;209(3):697-704. doi: 10.1148/radiology.209.3.9844661.


Purpose: To identify relationships between the obstructive defects of pulmonary sarcoidosis and the computed tomographic (CT) patterns of disease.

Material and methods: CT scans obtained in 45 patients were scored semiquantitatively for extent of five CT patterns, and the functional importance of each pattern was evaluated.

Results: The most prevalent CT patterns were decreased attenuation (n = 40), a reticular pattern (n = 37), and a nodular pattern (n = 36). At univariate and multivariate analyses, a reticular pattern was the main determinant of functional impairment, particularly airflow obstruction. The extent of a reticular pattern was independently associated with airflow obstruction, as shown by the inverse relationships with the forced expiratory volume in 1 second (FEV1) (P < .001), FEV1-forced vital capacity ratio (P < .01), maximum expiratory flow at 25% above residual volume (P < .001), and maximum expiratory flow at 50% above residual volume (P < .001) and the positive relationship with the residual volume-total lung capacity ratio (P < .001).

Conclusion: In sarcoidosis, CT features compatible with small airways disease are common but contribute little to airflow obstruction, particularly in more advanced disease, which is characterized by an extensive reticular pattern. A reticular pattern at CT is the major morphologic association of airflow obstruction.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Airway Obstruction / diagnostic imaging*
  • Airway Obstruction / etiology
  • Airway Obstruction / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Pulmonary Ventilation
  • Sarcoidosis, Pulmonary / complications
  • Sarcoidosis, Pulmonary / diagnostic imaging*
  • Sarcoidosis, Pulmonary / physiopathology
  • Tomography, X-Ray Computed* / methods