Department of Diagnostic Imaging, Federal University of São Paulo, Rua Napoleão de Barros 800, Vila Clementino 04024-002, São Paulo, Brazil.
Radiographics. 2012 Jan-Feb;32(1):33-50. doi: 10.1148/rg.321105058.
Collagen vascular diseases are a diverse group of immunologically mediated systemic disorders that often lead to thoracic changes. The collagen vascular diseases that most commonly involve the lung are rheumatoid arthritis, progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and dermatomyositis, mixed connective tissue disease, and Sjögren syndrome. Interstitial lung disease and pulmonary arterial hypertension are the main causes of mortality and morbidity among patients with collagen vascular diseases. Given the broad spectrum of possible thoracic manifestations and the varying frequency with which different interstitial lung diseases occur, the interpretation of thoracic images obtained in patients with collagen vascular diseases can be challenging. The task may be more difficult in the presence of treatment-related complications such as drug toxicity and infections, which are common in this group of patients. Although chest radiography is most often used for screening and monitoring of thoracic alterations, high-resolution computed tomography can provide additional information about lung involvement in collagen vascular diseases and may be especially helpful for differentiating specific disease patterns in the lung. General knowledge about the manifestations of thoracic involvement in collagen vascular diseases allows radiologists to provide better guidance for treatment and follow-up of these patients.
胶原血管疾病是一组免疫介导的系统性疾病,常导致胸部改变。最常累及肺部的胶原血管疾病包括类风湿关节炎、进行性系统性硬化症、系统性红斑狼疮、多发性肌炎和皮肌炎、混合性结缔组织病和干燥综合征。间质性肺疾病和肺动脉高压是胶原血管疾病患者死亡和发病的主要原因。鉴于可能出现的胸部表现范围广泛,不同间质性肺疾病的发生频率也不同,因此对胶原血管疾病患者获得的胸部图像进行解读具有挑战性。在存在与治疗相关的并发症(如药物毒性和感染)的情况下,这项任务可能更加困难,而这类并发症在这组患者中很常见。虽然胸部 X 线摄影最常用于筛查和监测胸部改变,但高分辨率计算机断层扫描可以提供关于胶原血管疾病肺部受累的更多信息,并且可能对区分肺部特定疾病模式特别有帮助。了解胶原血管疾病中胸部受累的表现可以使放射科医生更好地为这些患者的治疗和随访提供指导。