Jeong Yeon Joo, Lee Kyung Soo, Müller Nestor L, Chung Man Pyo, Chung Myung Jin, Han Joungho, Colby Thomas V, Kim Seonwoo
Department of Radiology and the Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Radiol. 2005 Jul-Sep;6(3):143-52. doi: 10.3348/kjr.2005.6.3.143.
We wanted to demonstrate and compare the serial high-resolution CTs (HRCT) and the pulmonary function test (PFT) findings of the usual interstitial pneumonia (UIP) and the non-specific interstitial pneumonia (NSIP).
The serial HRCT scans and the PFT results were retrospectively analysed and compared for 35 patients having UIP without significant honeycombing (UIP-w/o hc, < 5% of honeycombing at CT), 35 patients having UIP with honeycombing (UIP-w/i hc, > or = 5% of honeycombing), and 25 patients with NSIP. The mortality rates were also compared. Follow-up CT scans were available in 75 patients (29 UIP-w/o hc patients, 22 UIP-w/i hc patients and 24 NSIP patients) and the follow-up periods ranged from 150 to 2,370 days. The initial and follow-up PFT data were available for 71 patients.
On the initial CT, significant differences were present between the UIP-w/i hc patients and both the UIP-w/o hc patients and the NSIP patients in the overall extent, ground-glass opacity (GGO) away from the reticulation, reticulation and honeycombing (all p < 0.05). Improvement was noticed in five (17%) of 29 UIP-w/o hc patients, none of 22 UIP-w/i hc patients, and 9 (37%) of 24 NSIP patients; deterioration was noted in six (21%) UIP-w/o hc patients, two (9%) UIPw/i hc patients and three (13%) NSIP patients (p = 0.044 between UIP-w/o and UIP-w/i hc; p = 0.637 between UIP-w/o hc and NSIP; p = 0.007 between UIP-w/i hc and NSIP). The serial changes of the pulmonary function in the NSIP patients were different from those noted for the UIP-w/i hc and UIP-w/o hc patients (p = 0.440 between UIP-w/o and UIP-w/i hc; p = 0.022 between UIP-w/o hc and NSIP; p = 0.003 between UIP-w/i hc and NSIP). Five (14%) of the 35 patients with UIPw/o hc, 16 (46%) of the 35 patients with UIP-w/i hc and three (12%) of the 25 patients with NSIP died (p = 0.002, comparison for the three groups).
On CT, NSIP and UIP-w/o hc patients have similar patterns of parenchymal abnormalities and a similar likelihood of change in the extent of disease on follow-up. Patients with UIP-w/i hc have distinctive features and a worst prognosis.
我们旨在展示并比较普通型间质性肺炎（UIP）和非特异性间质性肺炎（NSIP）的系列高分辨率CT（HRCT）及肺功能测试（PFT）结果。
对35例无明显蜂窝状改变的UIP患者（UIP-w/o hc，CT上蜂窝状改变<5%）、35例有蜂窝状改变的UIP患者（UIP-w/i hc，蜂窝状改变≥5%）和25例NSIP患者的系列HRCT扫描及PFT结果进行回顾性分析和比较。还比较了死亡率。75例患者有随访CT扫描结果（29例UIP-w/o hc患者、22例UIP-w/i hc患者和24例NSIP患者），随访期为150至2370天。71例患者有初始和随访PFT数据。
在初始CT上，UIP-w/i hc患者与UIP-w/o hc患者及NSIP患者在总体范围、远离网状影的磨玻璃影（GGO）、网状影和蜂窝状改变方面均存在显著差异（均p<0.05）。29例UIP-w/o hc患者中有5例（17%）病情改善，22例UIP-w/i hc患者无改善，24例NSIP患者中有9例（37%）病情改善；29例UIP-w/o hc患者中有6例（21%）病情恶化，22例UIP-w/i hc患者中有2例（9%）病情恶化，24例NSIP患者中有3例（13%）病情恶化（UIP-w/o与UIP-w/i hc之间p = 0.044；UIP-w/o hc与NSIP之间p = 0.637；UIP-w/i hc与NSIP之间p = 0.007）。NSIP患者肺功能的系列变化与UIP-w/i hc和UIP-w/o hc患者不同（UIP-w/o与UIP-w/i hc之间p = 0.440；UIP-w/o hc与NSIP之间p = 0.022；UIP-w/i hc与NSIP之间p = 0.003）。35例UIP-w/o hc患者中有5例（14%）、35例UIP-w/i hc患者中有16例（46%）、25例NSIP患者中有3例（12%）死亡（三组比较p = 0.002）。
在CT上，NSIP和UIP-w/o hc患者的实质异常模式相似，随访时疾病范围变化的可能性相似。UIP-w/i hc患者有独特特征且预后最差。
