Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Flinders University - College of Medicine and Public Health, Adelaide, South Australia, Australia.
J Med Imaging Radiat Oncol. 2022 Apr;66(3):337-344. doi: 10.1111/1754-9485.13295. Epub 2021 Jul 27.
There is sparse evidence in the literature in relation to the chest computed tomography (CT) findings among adult Indigenous Australians with chronic respiratory conditions.
In this retrospective study, patients who underwent chest CT between 2012 and 2020 among those referred to undergo lung function tests (spirometry) were assessed for the prevalence of abnormal chest CT radiological findings.
Of the 402 patients (59% female) included in this study, 331 (82%) had an abnormality identified on chest CT. Most abnormalities occurred alongside one (25%) or multiple (46%) other CT abnormalities. Airway disease ((AD) (including, emphysema, airway wall thickening and small airway disease) (35%), atelectasis: segmental or lobar collapse (27%), inflammatory opacities (24%) and bronchiectasis (23%) were the most common findings. AD and bronchiectasis were also the most common concurrent abnormalities in 40-50%. Other CT abnormalities noted in isolation or in combination with other CT findings were lung nodules (19%), lymph node enlargement (17%), consolidation or mass (17%), followed by lung cysts, ground-glass opacity, lung parenchymal architectural distortion, cavitating lung lesions and chronic pleural effusion were observed in ≤10%. Predictive models for odds of abnormality and outcomes showed age, smoking and underweight were associated with AD, and male sex and very remote residence were associated with bronchiectasis.
This study has illustrated that Indigenous Australian adults have a high prevalence of multiple chest CT abnormalities that may impose unprecedented diagnostic and therapeutic challenges in this population. Further studies are warranted to determine the long-term implications and prognostic significance of the CT findings as demonstrated in this study.
在慢性呼吸系统疾病的成年澳大利亚原住民中，有关其胸部计算机断层扫描（CT）表现的文献证据很少。
在这项回顾性研究中，评估了在 2012 年至 2020 年期间接受肺功能检查（肺活量测定）的患者中，胸部 CT 异常放射学表现的患病率。
在纳入的 402 名患者（59%为女性）中，有 331 名（82%）在胸部 CT 上发现异常。大多数异常与一种（25%）或多种（46%）其他 CT 异常并存。气道疾病（包括肺气肿、气道壁增厚和小气道疾病）（35%）、肺不张（节段或肺叶塌陷）（27%）、炎症性混浊（24%）和支气管扩张症（23%）是最常见的发现。40-50 岁的患者中，气道疾病和支气管扩张症也是最常见的并存异常。孤立或与其他 CT 结果联合存在的其他 CT 异常包括肺结节（19%）、淋巴结肿大（17%）、实变或肿块（17%），其次是肺囊肿、磨玻璃影、肺实质结构扭曲、空洞性肺病变和慢性胸腔积液，其发生率均≤10%。对异常和结果的可能性进行预测的模型表明，年龄、吸烟和体重不足与气道疾病相关，而男性和非常偏远的居住地与支气管扩张症相关。
本研究表明，澳大利亚原住民成年人存在多种胸部 CT 异常的高发率，这可能对该人群带来前所未有的诊断和治疗挑战。需要进一步研究以确定本研究中所示 CT 结果的长期影响和预后意义。
