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定量计算机断层扫描可检测出经活检证实的间质性肺疾病。

Quantitative computed tomography detects interstitial lung diseases proven by biopsy.

作者信息

Ariani Alarico, Imperatori Andrea, Castiglioni Massimo, Daffrè Elisa, Aiello Marina, Bertorelli Giuseppina, Chetta Alfredo, Dominioni Lorenzo, Rotolo Nicola

机构信息

Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.

Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Ospedale di Circolo, Varese, Italy.

出版信息

Sarcoidosis Vasc Diffuse Lung Dis. 2018;35(1):16-20. doi: 10.36141/svdld.v35i1.6537. Epub 2018 Apr 28.

Abstract

The Quantitative chest CT (QCT) is emerging as a promising tool in the assessment of interstitial lung disease (ILD). However, the precise relationship between QCT parameters and the fibrosis detectable in lung tissue, remains to be established. The aim of this study was to compare QCT and histopathological features in patients with ILD. Moreover we verified if the QCT assessment is similar in patients with or without a ILD diagnosis proven by a biopsy. Twenty patients affected by ILD who underwent a chest CT and, later, a lung biopsy, were enrolled. Patients were divided according to the histopathological findings (IPF vs sarcoidosis) in two groups (respectively bIPF and bSarc). Other 20 patients with a radiological diagnosis of IPF were included in a control group (rIPF). All CTs were post-processed with a free software (Horos) in order to obtain an ILD quantitative assessment. There were no differences in terms of gender, smoking habit and spirometric values between patients' groups. rIPF subjects were older than the other: 70 vs 59 and 47 years (p<0.001). A different distribution of QCT parameters was observed between bIPF and bSarc (p<0.01) while it was comparable within bIPF and rIPF. QCT parameters were similar in subjects affected by the same type of ILD detected with biopsy and with CT alone. These findings make stronger the assumption that QCT can identify the presence of pulmonary fibrosis and, ultimately, that it can represent an useful and effective tool to assess ILD. .

摘要

定量胸部CT(QCT)正逐渐成为评估间质性肺疾病(ILD)的一种有前景的工具。然而,QCT参数与肺组织中可检测到的纤维化之间的确切关系仍有待确定。本研究的目的是比较ILD患者的QCT和组织病理学特征。此外,我们还验证了在经活检证实有或无ILD诊断的患者中,QCT评估是否相似。纳入了20例患有ILD且接受了胸部CT检查,随后又进行了肺活检的患者。根据组织病理学结果(特发性肺纤维化与结节病)将患者分为两组(分别为bIPF和bSarc)。另外20例经放射学诊断为特发性肺纤维化的患者被纳入对照组(rIPF)。所有CT图像均使用免费软件(Horos)进行后处理,以获得ILD的定量评估。患者组之间在性别、吸烟习惯和肺功能值方面没有差异。rIPF组的受试者年龄比其他组大:分别为70岁、59岁和47岁(p<0.001)。在bIPF和bSarc之间观察到QCT参数的分布不同(p<0.01),而在bIPF组和rIPF组内具有可比性。活检和单独CT检测出的相同类型ILD患者的QCT参数相似。这些发现进一步支持了QCT可以识别肺纤维化的存在,最终,它可以成为评估ILD的一种有用且有效的工具这一假设。

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