Ahmed Shadab, Khanduri Sachin, Husain Mushahid, Khan Ahmad Umar, Singh Anchal, Rajurkar Mridul, Abbas Syed Zain, Khan Nazia
Radiodiagnosis, Era's Lucknow Medical College and Hospital, Lucknow, IND.
Radiology, Era's Lucknow Medical College and Hospital, Lucknow, IND.
Cureus. 2020 May 23;12(5):e8253. doi: 10.7759/cureus.8253.
Background Multidetector CT (MDCT) has emerged as a useful option for early diagnosis of interstitial lung disease (ILD) with adequate accuracy. Methods A total of 80 patients with restricted pulmonary functions and clinical suspicion of ILD were enrolled in the study. MDCT evaluation was done using Siemens Somatom Force 384 slice multidetector computer tomography machine. Pattern analysis for reticular opacities, nodules and lung opacities was done to reach at a diagnosis. Final diagnosis was based on correlation of radiological and clinicopathological findings. Diagnostic efficacy of MDCT was evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy for detection of ILD. Results Mean age of patients was 58 ± 8.75 years. Majority were females (51.3%). History of chronic obstructive pulmonary disease (COPD), tuberculosis and bronchial asthma was revealed in 31 (38.8%), 26 (32.5%) and 16 (20%) patients, respectively. There were 30 (37.5%) patients having no history of respiratory diseases. MDCT diagnosed ILD in 45 (56.3%) cases. On final diagnosis, ILD was diagnosed in 35 (43.8%) cases (15 usual interstitial pneumonia [UIP], 9 cryptogenic organizing pneumonia [COP], 8 nonspecific interstitial pneumonia [NSIP] and 3 respiratory bronchiolitis associated interstitial lung disease [RBILD]). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MDCT in detection of ILD was 91.4%, 71.1%, 71.1%, 91.4% and 80%, respectively. Conclusion MDCT as a single modality had a high sensitivity for detection of ILD and could be recommended as first line diagnostic imaging technique.
背景 多排螺旋CT(MDCT)已成为早期诊断间质性肺疾病(ILD)的一种有效手段,具有足够的准确性。方法 本研究共纳入80例肺功能受限且临床怀疑为ILD的患者。使用西门子Somatom Force 384层多排螺旋计算机断层扫描仪进行MDCT评估。对网状阴影、结节和肺部阴影进行模式分析以做出诊断。最终诊断基于影像学和临床病理结果的相关性。从敏感性、特异性、阳性预测值(PPV)、阴性预测值(NPV)和检测ILD的准确性方面评估MDCT的诊断效能。结果 患者的平均年龄为58±8.75岁。大多数为女性(51.3%)。分别有31例(38.8%)、26例(32.5%)和16例(20%)患者有慢性阻塞性肺疾病(COPD)、肺结核和支气管哮喘病史。有30例(37.5%)患者无呼吸系统疾病史。MDCT诊断出45例(56.3%)ILD。最终诊断时,35例(43.8%)患者被诊断为ILD(15例为普通型间质性肺炎[UIP],9例为隐源性机化性肺炎[COP],8例为非特异性间质性肺炎[NSIP],3例为呼吸性细支气管炎伴间质性肺疾病[RBILD])。MDCT检测ILD的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为91.4%、71.1%、71.1%、91.4%和80%。结论 MDCT作为单一检查手段对ILD的检测具有较高的敏感性,可推荐作为一线诊断成像技术。