Wangkaew Suparaporn, Euathrongchit Juntima, Wattanawittawas Pittaporn, Kasitanon Nuntana
Division of Rheumatology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Division of Diagnostic Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Quant Imaging Med Surg. 2016 Aug;6(4):381-390. doi: 10.21037/qims.2016.08.08.
The correlation of changes (delta: Δ) of high-resolution computed tomography (HRCT) score with the Δ of other clinical variables has not been well studied. The purpose of this study was to determine the correlation of Δ HRCT score with Δ percent predicted forced vital capacity (%pFVC), Δ modified Rodnan Skin Score (mRSS), Δ erythrocyte sedimentation rate (ESR), and Δ percent of oxygen saturation at room air (%SpO) in patients with early systemic sclerosis (SSc).
We used an inception cohort of early-SSc patients seen at the Rheumatology Clinic, Chiang Mai University, Thailand, between January 2010 and June 2014. All patients underwent HRCT at study entry and every 12 months thereafter. Thirty-one SSc patients who underwent pulmonary function test (PFT) within 12 weeks of their corresponding HRCT at baseline and last visit were identified. The extent of ground glass (GG), lung fibrosis (Fib), bronchiectasis (B), and honeycombing (HC) was scored, and then aggregated to produce a total (t) HRCT score.
Mean ± SD age and disease duration from non-Raynaud's phenomenon (NRP) to undergo HRCT at baseline were 52.2±8.8 years and 11.7±7.1 months, respectively. Seventeen (54.8%) patients were female and 20 (64.5%) were classified as dcSSc. The mean ± SD interval between the two HRCT tests was 16.0±7.2 months. The Δ HRCT scores [total fibrosis scores (t-Fib), total bronchiectasis scores (t-B), and total HRCT score (t-HRCT) scores] and Δ mRSS, but not Δ %pFVC, showed significant change over the observation period. We found significant correlation of Δ total honeycombing scores (t-HC) with Δ ESR (r=-0.44, P<0.05), and Δ t-Fib with Δ %SpO (r=-0.38, P<0.05). However, no significant correlation of any Δ HRCT scores with Δ %pFVC and Δ mRSS were observed.
In this study, the changes in the HRCT scores were greater than %pFVC; this, along with their correlations with the changes in ESR and %SpO, suggest that HRCT scores are a useful and sensitive method for monitoring disease progression in early SSc-related ILD (SSc-ILD).
高分辨率计算机断层扫描（HRCT）评分变化（差值：Δ）与其他临床变量变化之间的相关性尚未得到充分研究。本研究的目的是确定早期系统性硬化症（SSc）患者中HRCT评分变化与预测用力肺活量变化百分比（%pFVC）、改良Rodnan皮肤评分变化（mRSS）、红细胞沉降率变化（ESR）以及室内空气下氧饱和度百分比变化（%SpO）之间的相关性。
我们纳入了2010年1月至2014年6月在泰国清迈大学风湿病诊所就诊的早期SSc患者起始队列。所有患者在研究开始时及此后每12个月接受一次HRCT检查。确定了31例在基线和末次就诊时相应HRCT检查后12周内进行肺功能测试（PFT）的SSc患者。对磨玻璃影（GG）、肺纤维化（Fib）、支气管扩张（B）和蜂窝肺（HC）的范围进行评分，然后汇总得出总（t）HRCT评分。
基线时非雷诺现象（NRP）接受HRCT检查时的平均年龄±标准差和病程分别为52.2±8.8岁和11.7±7.1个月。17例（54.8%）患者为女性；20例（64.5%）被分类为弥漫性皮肤型SSc（dcSSc）类型。两次HRCT检查之间的平均间隔时间±标准差为16.0±7.2个月。在观察期内，HRCT评分变化[总纤维化评分（t - Fib）、总支气管扩张评分（t - B）和总HRCT评分（t - HRCT）]以及mRSS变化显著，但%pFVC变化不显著。我们发现总蜂窝肺评分变化（t - HC）与ESR变化显著相关（r = -0.44，P < 0.05），总纤维化评分变化（t - Fib）与%SpO变化显著相关（r = -0.38，P < 0.05）。然而，未观察到任何HRCT评分变化与%pFVC变化和mRSS变化之间存在显著相关性。
在本研究中HRCT评分变化大于%pFVC变化；这一点以及它们与ESR变化和%SpO变化的相关性表明，HRCT评分是监测早期SSc相关间质性肺病（SSc - ILD）疾病进展的一种有用且敏感方法
