Department of Radiology, Osaka International Cancer Institute, 3 Chome-1-69 Ootemae, Chuou-ku, Osaka, 541-8567, Japan.
Department of Diagnostic Radiology, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai, 593-8304, Japan.
Jpn J Radiol. 2019 Mar;37(3):230-236. doi: 10.1007/s11604-018-0805-5. Epub 2019 Jan 1.
To evaluate the incidence and changes in the pleuroparenchymal fibroelastosis (PPFE)-like lesions on chest CT in routine clinical practice.
This study included 1284 patients who underwent chest CT in 2011 at a hospital. The incidence of PPFE-like lesions and their correlation with age, body mass index, and concomitant pulmonary findings were assessed. Moreover, predictors of lesion progression were evaluated on follow-up. The ethical review board waived the requirement of informed consent for the retrospective review of patient records.
In total, 397 (30.9%) of the 1284 patients presented with PPFE-like lesions. The presence of PPFE-like lesions was correlated with older age (mean 72.2 vs. 69.9 years, p = 0.002); lower BMI (mean 21.0 vs. 23.2, p < 0.001); and interstitial pneumonia (64.8%, p < 0.001), emphysema (40.4%, p < 0.001), chronic airway disease (64.8%, p < 0.001), and old tuberculosis (56.5%, p < 0.001). Multivariate analysis of the follow-up CT findings revealed that interstitial pneumonia, nodular opacity, and lesion thickness affected progression (odds ratio: 3.81, 3.78 and 1.21), respectively.
Pleuroparenchymal fibroelastosis-like lesions were not rare and correlated with interstitial pneumonia, emphysema, chronic airway disease, and old tuberculosis. On follow-up, PPFE-like lesions in some patients with concomitant interstitial pneumonia exhibited progression.
在常规临床实践中评估胸部 CT 中胸膜肺弹力纤维增生症(PPFE)样病变的发生率和变化。
本研究纳入了 2011 年在一家医院接受胸部 CT 检查的 1284 例患者。评估了 PPFE 样病变的发生率及其与年龄、体重指数和并存肺部发现的相关性。此外,还评估了随访时病变进展的预测因素。伦理审查委员会豁免了对患者记录进行回顾性审查的知情同意要求。
在总共 1284 例患者中,有 397 例(30.9%)存在 PPFE 样病变。PPFE 样病变的存在与年龄较大(平均 72.2 岁 vs. 69.9 岁,p=0.002)、较低的 BMI(平均 21.0 岁 vs. 23.2 岁,p<0.001)、间质性肺炎(64.8%,p<0.001)、肺气肿(40.4%,p<0.001)、慢性气道疾病(64.8%,p<0.001)和陈旧性肺结核(56.5%,p<0.001)相关。对随访 CT 发现的多变量分析表明,间质性肺炎、结节状不透明和病变厚度分别影响进展(比值比:3.81、3.78 和 1.21)。
胸膜肺弹力纤维增生症样病变并不罕见,与间质性肺炎、肺气肿、慢性气道疾病和陈旧性肺结核有关。在随访中,一些伴有间质性肺炎的患者的 PPFE 样病变出现进展。