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高分辨率计算机断层扫描:改善系统性硬化症相关间质性肺病患者护理中的利弊

High-Resolution Computed Tomography: Lights and Shadows in Improving Care for SSc-ILD Patients.

作者信息

Ruaro Barbara, Baratella Elisa, Confalonieri Paola, Wade Barbara, Marrocchio Cristina, Geri Pietro, Busca Annalisa, Pozzan Riccardo, Andrisano Alessia Giovanna, Cova Maria Assunta, Confalonieri Marco, Salton Francesco

机构信息

Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy.

Department of Radiology, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy.

出版信息

Diagnostics (Basel). 2021 Oct 22;11(11):1960. doi: 10.3390/diagnostics11111960.

Abstract

The diagnosis and classification of systemic sclerosis-associated interstitial lung disease (SSc-ILD) is essential to improve the prognosis of systemic sclerosis (SSc) patients. The risk-stratification of disease severity and follow-up requires a multidisciplinary approach, integrating high-resolution computed tomography (HRTC) of the lung, pulmonary function tests (PFT), along with clinical and symptomatic evaluations. The use of HRCT in detecting SSc-ILD is not so much based on a definitive validation, but rather reflects the widespread clinician recognition of dissatisfaction with other modalities. However, due to the heterogeneity of SSc-ILD and the potential absence of symptoms in early or mild disease, it is prudent to consider as many parameters as possible in the assessment and monitoring of newly diagnosed patients. An early diagnosis meets the primary goal, i.e., the prevention of disease progression. The current first line treatment regimens are mainly centered on immunosuppressive therapy. This review assesses the role HRCT plays in optimizing care and improving clinical outcomes in SSc-ILD patients.

摘要

系统性硬化症相关间质性肺病(SSc-ILD)的诊断和分类对于改善系统性硬化症(SSc)患者的预后至关重要。疾病严重程度的风险分层和随访需要多学科方法,整合肺部高分辨率计算机断层扫描(HRTC)、肺功能测试(PFT)以及临床和症状评估。HRCT在检测SSc-ILD中的应用并非基于明确的验证,而是反映了临床医生对其他方式普遍不满的认可。然而,由于SSc-ILD的异质性以及早期或轻度疾病可能无症状,在评估和监测新诊断患者时考虑尽可能多的参数是谨慎的做法。早期诊断符合主要目标,即预防疾病进展。目前的一线治疗方案主要集中在免疫抑制治疗上。本综述评估了HRCT在优化SSc-ILD患者护理和改善临床结局中所起的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/42c9/8617987/2f26ba458681/diagnostics-11-01960-g001.jpg

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