Tanaka N, Kunihiro Y, Kubo M, Kawano R, Oishi K, Ueda K, Gondo T
Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan; Department of Radiology, Saiseikai Yamaguchi General Hospital, 2-11 Midoricho, Yamaguchi, Yamaguchi 753-8517, Japan.
Department of Radiology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan; Department of Radiology, National Hospital Organization,Yamaguchi - Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan.
Clin Radiol. 2018 Sep;73(9):833.e1-833.e10. doi: 10.1016/j.crad.2018.04.017. Epub 2018 May 30.
To identify characteristic high-resolution computed tomography (CT) findings for individual collagen vascular disease (CVD)-related interstitial pneumonias (IPs).
The HRCT findings of 187 patients with CVD, including 55 patients with rheumatoid arthritis (RA), 50 with systemic sclerosis (SSc), 46 with polymyositis/dermatomyositis (PM/DM), 15 with mixed connective tissue disease, 11 with primary Sjögren's syndrome, and 10 with systemic lupus erythematosus, were evaluated. Lung parenchymal abnormalities were compared among CVDs using χ test, Kruskal-Wallis test, and multiple logistic regression analysis. A CT-pathology correlation was performed in 23 patients.
In RA-IP, honeycombing was identified as the significant indicator based on multiple logistic regression analyses. Traction bronchiectasis (81.8%) was further identified as the most frequent finding based on χ test. In SSc IP, lymph node enlargement and oesophageal dilatation were identified as the indicators based on multiple logistic regression analyses, and ground-glass opacity (GGO) was the most extensive based on Kruskal-Wallis test, which reflects the higher frequency of the pathological nonspecific interstitial pneumonia (NSIP) pattern present in the CT-pathology correlation. In PM/DM IP, airspace consolidation and the absence of honeycombing were identified as the indicators based on multiple logistic regression analyses, and predominance of consolidation over GGO (32.6%) and predominant subpleural distribution of GGO/consolidation (41.3%) were further identified as the most frequent findings based on χ test, which reflects the higher frequency of the pathological NSIP and/or the organising pneumonia patterns present in the CT-pathology correlation.
Several characteristic high-resolution CT findings with utility for estimating underlying CVD were identified.
确定个体胶原血管病（CVD）相关间质性肺炎（IP）的高分辨率计算机断层扫描（CT）特征性表现。
评估了187例CVD患者的高分辨率CT表现，其中包括55例类风湿关节炎（RA）患者、50例系统性硬化症（SSc）患者、46例多发性肌炎/皮肌炎（PM/DM）患者、15例混合性结缔组织病患者、11例原发性干燥综合征患者和10例系统性红斑狼疮患者。使用χ检验、Kruskal-Wallis检验和多因素逻辑回归分析比较了不同CVD之间的肺实质异常情况。对23例患者进行了CT与病理的相关性分析。
在RA-IP中，基于多因素逻辑回归分析，蜂窝状改变被确定为显著指标。基于χ检验，牵拉性支气管扩张（81.8%）被进一步确定为最常见的表现。在SSc-IP中，基于多因素逻辑回归分析，淋巴结肿大和食管扩张被确定为指标，基于Kruskal-Wallis检验，磨玻璃影（GGO）最为广泛，这反映了CT与病理相关性中病理非特异性间质性肺炎（NSIP）模式的较高发生率。在PM/DM-IP中，基于多因素逻辑回归分析，气腔实变和无蜂窝状改变被确定为指标，基于χ检验，实变多于GGO（32.6%）以及GGO/实变主要分布于胸膜下（41.3%）被进一步确定为最常见的表现，这反映了CT与病理相关性中病理NSIP和/或机化性肺炎模式的较高发生率。
确定了几种有助于评估潜在CVD的特征性高分辨率CT表现。
