Bruni Cosimo, Occhipinti Mariaelena, Pienn Michael, Camiciottoli Gianna, Bartolucci Maurizio, Bosello Silvia Laura, Payer Christian, Bálint Zoltán, Larici Anna Rita, Tottoli Alessandra, Tofani Lorenzo, De Lorenzis Enrico, Lepri Gemma, Bellando-Randone Silvia, Spinella Amelia, Giuggioli Dilia, Masini Francesco, Cuomo Giovanna, Lavorini Federico, Colagrande Stefano, Olschewski Horst, Matucci-Cerinic Marco
Division of Rheumatology, Deptartment of Experimental and Clinical Medicine, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy.
Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Rheumatology (Oxford). 2023 Feb 1;62(2):696-706. doi: 10.1093/rheumatology/keac311.
It has recently become possible to assess lung vascular and parenchymal changes quantitatively in thoracic CT images using automated software tools. We investigated the vessel parameters of patients with SSc, quantified by CT imaging, and correlated them with interstitial lung disease (ILD) features.
SSc patients undergoing standard of care pulmonary function testing and CT evaluation were retrospectively evaluated. CT images were analysed for ILD patterns and total pulmonary vascular volume (PVV) extents with Imbio lung texture analysis. Vascular analysis (volumes, numbers and densities of vessels, separating arteries and veins) was performed with an in-house developed software. A threshold of 5% ILD extent was chosen to define the presence of ILD, and commonly used cut-offs of lung function were adopted.
A total of 79 patients [52 women, 40 ILD, mean age 56.2 (s.d. 14.2) years, total ILD extent 9.5 (10.7)%, PVV/lung volume % 2.8%] were enrolled. Vascular parameters for total and separated PVV significantly correlated with functional parameters and ILD pattern extents. SSc-associated ILD (SSc-ILD) patients presented with an increased number and volume of arterial vessels, in particular those between 2 and 4 mm of diameter, and with a higher density of arteries and veins of <6 mm in diameter. Considering radiological and functional criteria concomitantly, as well as the descriptive trends from the longitudinal evaluations, the normalized PVVs, vessel numbers and densities increased progressively with the increase/worsening of ILD extent and functional impairment.
In SSc patients CT vessel parameters increase in parallel with ILD extent and functional impairment, and may represent a biomarker of SSc-ILD severity.
最近，使用自动化软件工具在胸部CT图像中定量评估肺血管和实质变化已成为可能。我们研究了通过CT成像量化的系统性硬化症（SSc）患者的血管参数，并将其与间质性肺疾病（ILD）特征相关联。
对接受标准护理肺功能测试和CT评估的SSc患者进行回顾性评估。使用Imbio肺纹理分析对CT图像进行ILD模式和总肺血管容积（PVV）范围分析。使用自行开发的软件进行血管分析（血管的容积、数量和密度，区分动脉和静脉）。选择5%的ILD范围阈值来定义ILD的存在，并采用常用的肺功能临界值。
共纳入79例患者[52例女性，40例患有ILD，平均年龄56.2（标准差14.2）岁，总ILD范围9.5（10.7）%，PVV/肺容积%2.8%]。总PVV和分离的PVV的血管参数与功能参数和ILD模式范围显著相关。与SSc相关的ILD（SSc-ILD）患者的动脉血管数量和容积增加，特别是直径在2至4毫米之间的血管，并且直径<6毫米的动脉和静脉密度更高。同时考虑放射学和功能标准以及纵向评估的描述性趋势，标准化的PVV、血管数量和密度随着ILD范围的增加/恶化和功能损害而逐渐增加。
在SSc患者中，CT血管参数与ILD范围和功能损害平行增加，可能代表SSc-ILD严重程度的生物标志物。
