Fenlon H M, Doran M, Sant S M, Breatnach E
Department of Radiology, Mater Misericordiae Hospital, Dublin, Ireland.
AJR Am J Roentgenol. 1996 Feb;166(2):301-7. doi: 10.2214/ajr.166.2.8553934.
The purpose of our study was to identify high-resolution CT (HRCT) findings in patients with systemic lupus erythematosus (SLE) and to determine their significance by correlation with clinical findings, plain chest radiography, and pulmonary function testing.
Thirty-four patients with documented SLE were prospectively studied. All patients had plain chest radiography (posteroanterior and lateral) thoracic spiral CT, HRCT, and pulmonary function testing performed.
HRCT abnormalities were identified in 24 patients (70%), pulmonary function abnormalities were present in only 14 patients (41%), and the plain chest radiograph was abnormal in only 8 patients (24%). The most common CT findings were: interstitial lung disease (n = 11), bronchiectasis (n = 7), mediastinal or axillary lymphadenopathy (n =6), and pleuropericardial abnormalities (n =5). No correlation was found between disease activity, duration of disease, chest symptoms, drug therapy, smoking history, and the presence of abnormal HRCT findings. More importantly, no correlation was found between pulmonary function abnormalities and the presence or grade of interstitial lung disease or bronchiectasis as determined by HRCT.
The results of this study, the first to describe the HRCT findings in SLE, suggest that airways disease, lymphadenopathy, and interstitial lung disease are common thoracic manifestations of SLE, whereas pleural abnormalities are less common than previously suggested. HRCT evidence of airways disease and interstitial lung disease was frequently present despite an absence of symptoms, a normal chest radiograph, and normal pulmonary function testing. HRCT provides a sensitive and noninvasive technique for detecting pulmonary involvement in SLE, with the added advantage that it can be performed in all patients, including those too compromised to undergo a surgical procedure. In patients with advanced disease, HRCT permits procedures such as bronchoalveolar lavage and lung biopsy to be directed toward areas of particular interest.
本研究旨在确定系统性红斑狼疮（SLE）患者的高分辨率CT（HRCT）表现，并通过与临床症状、胸部X线平片及肺功能检查结果进行关联分析，以明确其意义。
前瞻性研究34例确诊为SLE的患者。所有患者均接受胸部X线正侧位片、胸部螺旋CT、HRCT及肺功能检查。
24例（70%）患者出现HRCT异常，仅14例（41%）患者存在肺功能异常，而胸部X线平片异常者仅8例（24%）。最常见的CT表现为：间质性肺疾病（n = 11）、支气管扩张（n = 7）、纵隔或腋窝淋巴结肿大（n = 6）及胸膜心包异常（n = 5）。未发现疾病活动度、病程、胸部症状、药物治疗、吸烟史与HRCT异常表现之间存在相关性。更重要的是，未发现肺功能异常与HRCT所确定的间质性肺疾病或支气管扩张的存在或分级之间存在相关性。
本研究首次描述了SLE患者的HRCT表现，结果提示气道疾病、淋巴结肿大及间质性肺疾病是SLE常见的胸部表现，而胸膜异常比以往认为的更为少见。尽管无症状、胸部X线平片正常及肺功能检查正常，但气道疾病和间质性肺疾病的HRCT表现仍较为常见。HRCT为检测SLE患者肺部受累情况提供了一种敏感且无创的技术，其额外优势在于所有患者均可进行此项检查，包括那些病情严重无法接受手术的患者。对于晚期患者，HRCT可指导支气管肺泡灌洗和肺活检等操作针对特定感兴趣区域进行。
