Silva C Isabela S, Müller Nestor L, Hansell David M, Lee Kyung S, Nicholson Andrew G, Wells Athol U
Department of Radiology, Vancouver General Hospital, University of British Columbia, 3350-950 W 10th Ave, Vancouver, BC, Canada V5Z 4E3.
Radiology. 2008 Apr;247(1):251-9. doi: 10.1148/radiol.2471070369. Epub 2008 Feb 12.
To retrospectively assess the change in disease pattern of nonspecific interstitial pneumonia (NSIP) and idiopathic pulmonary fibrosis (IPF) findings seen at thin-section computed tomography (CT) at long-term follow-up and to compare the same with initial findings at CT.
The study included 48 patients (28 men, 20 women; mean age, 57.5 years) with biopsy-proved NSIP (n = 23) or IPF (n = 25) who underwent CT at initial diagnosis and at follow-up 34-155 months later. The CT scans were randomized and reviewed by two independent thoracic radiologists for pattern and distribution of ground-glass opacity (GGO), reticulation, traction bronchiectasis and bronchiolectasis, and honeycombing. Statistical analysis was performed by using nonparametric methods and univariate logistic regression.
Follow-up CT in patients with NSIP showed marked decrease in the extent of GGO, increase in reticulation, and a greater likelihood of peripheral distribution (all P < .05). At presentation, the CT findings were interpreted as suggestive of NSIP in 18 of 23 patients with NSIP and indeterminate or suggestive of IPF in five. In five (28%) of 18 patients with initial findings suggestive of NSIP, the follow-up CT scans were interpreted as more suggestive of IPF. No CT features seen at presentation allowed distinction between patients with NSIP that maintained an NSIP pattern at follow-up and those that progressed to an IPF pattern.
At follow-up CT, 28% of patients with initial CT findings suggestive of NSIP progressed to findings suggestive of IPF. Similar initial CT findings for NSIP may have different imaging outcomes.
回顾性评估非特异性间质性肺炎（NSIP）和特发性肺纤维化（IPF）在薄层计算机断层扫描（CT）上的疾病模式变化，并将其与CT初始表现进行比较。
本研究纳入48例患者（28例男性，20例女性；平均年龄57.5岁），经活检证实为NSIP（n = 23）或IPF（n = 25），这些患者在初始诊断时及34 - 155个月后的随访时均接受了CT检查。CT扫描结果随机分组，由两名独立的胸放射科医生进行评估，观察磨玻璃影（GGO）、网状影、牵拉性支气管扩张和细支气管扩张以及蜂窝状影的模式和分布。采用非参数方法和单因素逻辑回归进行统计分析。
NSIP患者的随访CT显示GGO范围明显减小，网状影增加，且外周分布的可能性更大（均P <.05）。初诊时，23例NSIP患者中有18例的CT表现提示为NSIP，5例为不确定或提示为IPF。在18例初诊表现提示为NSIP的患者中，有5例（28%）的随访CT扫描结果更提示为IPF。初诊时所见的CT特征无法区分随访时维持NSIP模式的NSIP患者和进展为IPF模式的患者。
在随访CT中，28%初诊CT表现提示为NSIP的患者进展为提示IPF的表现。NSIP相似的初始CT表现可能有不同的影像学结果。
