scholarly journals P16‐83: HRCT scoring focused on ground‐glass opacity, perilobular opacity, airspace consolidation, and interlobular septal thickening is useful for interstitial lung disease accompanied by anti‐MDA5 antibody‐positive dermatomyositis

Respirology ◽  
2021 ◽  
Vol 26 (S3) ◽  
pp. 484-484
2015 ◽  
Vol 9 (1) ◽  
pp. 0-0
Author(s):  
Бестаев ◽  
D. Bestaev ◽  
Божьева ◽  
L. Bozheva

Rheumatoid arthritis is an inflammatory rheumatic disease with unknown etiology characterized by symmetric, chronic and erosive arthritis (synovitis) of the peripheral joints and systemic inflammatory involvement of the viscera. Lung pathology, including interstitial lung disease, is one of the common extra-articular manifestations at the гheumatoid arthritis. The leading diagnosis method of interstitial lung disease is a computed tomography high resolution, which allows to identifying interstitial lung changes in 70% of the cases. The study of prognosis in patients with rheumatoid arthritis interstitial lung disease has been the subject of several studies in the past decade. In most studies it was stated that the average life expectancy from diagnosis is around 3 years. This work is devoted to study of interstitial lung disease as one of the most frequent extra-articular ma-nifestations of rheumatoid arthritis. The authors defined the significance of computed tomography high resolu-tion for the diagnosis of pulmonary interstitial lung changes at rheumatoid arthritis. They give comparative clini-cal and immunological, instrumental characteristics of rheumatoid arthritis patients with interstitial lung disease and without it. The role of smoking and positivity of anti-cyclic citrullinated peptide (anti-CCP) according to antibodies are determined as risk factors of interstitial lung disease development in patients with rheumatoid arthritis. The interrelation of the X-ray tomography symptom of interstitial lung disease "ground glass opacity" with the activity and duration of rheumatoid arthritis is revealed. "Ground glass opacity" symptom is associated with high index of DAS28 in patients with rheumatoid arthritis with interstitial lung disease.


2020 ◽  
Vol 9 (11) ◽  
pp. 3776
Author(s):  
Marlee S. Crews ◽  
Brian J. Bartholmai ◽  
Ayodeji Adegunsoye ◽  
Justin M. Oldham ◽  
Steven M. Montner ◽  
...  

This study aimed to determine diagnostic and prognostic differences in major forms of interstitial lung disease using quantitative CT imaging. A retrospective study of 225 subjects with a multidisciplinary diagnosis of idiopathic pulmonary fibrosis (IPF), interstitial pneumonia with autoimmune features (IPAF), connective tissue disease (CTD), or chronic hypersensitivity pneumonitis (cHP) was conducted. Non-contrast CT scans were analyzed using the Computer Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) program. Resulting data were analyzed statistically using ANOVA and Student’s t-test. Univariate, multivariable, and receiver operating characteristic analyses were conducted on patient mortality data. CALIPER analysis of axial distribution on CT scans in those with IPF demonstrated greater peripheral volumes of reticulation than either CTD (p = 0.033) or cHP (p = 0.007). CTD showed lower peripheral ground-glass opacity than IPF (p = 0.005) and IPAF (p = 0.004). Statistical analysis of zonal distributions revealed reduced lower zone ground-glass opacity in cHP than IPF (p = 0.044) or IPAF (p = 0.018). Analysis of pulmonary vascular-related structure (VRS) volume by diagnosis indicated greater VRS volume in IPF compared to CTD (p = 0.003) and cHP (p = 0.003) as well as in IPAF compared to CTD (p = 0.007) and cHP (p = 0.007). Increased reticulation (p = 0.043) and ground glass opacity (p = 0.032) were predictive of mortality on univariate analysis. Increased pulmonary VRS volume was predictive of mortality (p < 0.001) even after multivariate analysis (p = 0.041). Quantitative CT imaging revealed significant differences between ILD diagnoses in specific CT findings in axial and, to a lesser degree, zonal distributions. Increased pulmonary VRS volume seems to be associated with both diagnosis and survival.


2020 ◽  
pp. 1-7

Objective: To study the dynamic changes in CT findings in COVID-19 (coronavirus disease-19, COVID-19) rehabilitated patients. Methods: A total of 148 chest CT images of 37 patients with COVID-19 were collected. In the first 21 days of the course of disease, 7 stages were performed every 3 days, and the eighth stage was performed after 21 days. Results: In the first chest CT examination, 19 cases were ground glass opacity, and 18 cases were high-density shadows with consolidation. The lesion shape was flaky and patchy in 33 cases. The percentage of consolidation, air bronchogram, fiber cord, interlobular septal thickening, subpleural line and pleural thickening were the highest on days 4-6, 7-9, 7-9, 10-12, 19-21 and 19-21, respectively. The highest percentage of disease progression was 80.00% on days 4-6, and then the percentage of disease progression gradually decreased with the extension of the onset time. The percentage of patients with improvement gradually increased from days 4-6, reaching 83.33% on days 16-18 and 100.00% on day 21. The percentage of lesion range enlargement and density increase was the highest on days 4-6, both of which were 60.00%,Then the percentage of both decreased gradually. The percentage of patients with lesion range reduction and density absorption dilution increased gradually with the onset time. There was no obvious regularity in the number of lesions. Conclusion: Patients with COVID-19 have regular changes in their lung conditions.


2020 ◽  
Vol 8 (1) ◽  
pp. 9-13
Author(s):  
Jagruti Kalola ◽  
Anjana Trivedi ◽  
Hiral Happani ◽  
Mohit Chauhan

Background: The aim of this paper was to evaluate the thoracic manifestations associated with the Connective tissue disorders, with an emphasis on interstitial and airway disease pattern on the High Resolution computed tomography (HRCT) findings. Subjects and Methods: The present study was conducted for a period of one year. A total of 50 patients with various connective tissue disorders having respiratory complaints were evaluated. Results:  During the study period 50 patients (80%females and 20%males) underwent evaluation. Cough and dyspnea were  the most common presenting symptoms. Variety of thoracic abnormalities weredetected in 67 (95%) cases. Most common abnormality detected on HRCT was interstitial fibrosis/interstitial lung disease present in (60%) cases. Most common parenchymal abnormalities seen were reticulations (61.4%), ground glass opacification (40%), mosaic attenuation (32.8%) and honeycombing (24.3%). Airway abnormalities seen were bronchiectasis (48.5%), emphysema (12.8%), and ground glass nodules (2.8%). Conclusion: Interstitial lung disease is the most common pulmonary manifestation among patients with connective tissue disorders, and early detection and prompt treatment is expected to improve the outcome.


2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 29-33
Author(s):  
Ruza Stevic ◽  
Vucinic Mihailovic ◽  
Dragana Jovanovic ◽  
Nada Vasic

Introduction. Interstitial lung diseases include the entities of idiopathic pulmonary fibrosis, nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, desquamative interstitial pneumonia, and lymphocytic interstitial pneumonia. Recent introduction of high-resolution computed tomography has made the diagnosis of interstitial lung disease much easier. Usual interstitial pneumonia A predominantly subpleural reticulation and honeycombing at the basal posterior part of the lung with a progression to anterior and superior parts are characteristic of usual interstitial pneumonia/ idiopathic pulmonary fibrosis. Nonspecific interstitial pneumonia Typical findings of nonspecific interstitial pneumonia are bilateral, relatively symmetrical subpleural ground glass opacifications and irregular linear opacities. Desquamative interstitial pneumonia is characterized by diffuse symmetrical ground glass opacifications. Respiratory bronchiolitisassociated interstitial lung disease Centrilobular nodules and irregular ground glass opacifications are present. Cryptogenic organizing pneumonia Subpleural and peribronchial consolidations are prominent findings that are not present in other idiopathic interstitial pneumonias. Acute interstitial pneumonia. Bilateral ground-glass opacifications are present and areas of peripheral consolidations may also be seen in acute interstitial pneumonia. Lymphocytic interstitial pneumonia. Diffuse or patchy areas of ground glass opacification with centrilobular nodules and occasionally well-defined cysts are seen. Conclusion. Imaging plays a crucial role in identifying interstitial lung diseases but precise diagnosis requires a dynamic interdisciplinary approach that correlates clinical, radiological and pathologic features.


2021 ◽  
Author(s):  
Yuko Waseda ◽  
Takeshi Johkoh ◽  
Helmut Prosch ◽  
Stefan Nemec ◽  
Keigo Saeki ◽  
...  

ABSTRACT Objectives Interstitial lung disease (ILD) associated with the antimelanoma differentiation-associated protein 5 (anti-MDA5) antibody is a rapidly progressive disease that requires timely, aggressive treatment. However, prompt diagnosis is difficult due to the longer time required for antibody detection. This study described the computed tomography (CT) findings of anti-MDA5 antibody-positive ILD (anti-MDA5-ILD). Methods CT findings of 20 patients (7 men, 13 women; mean age, 53.6 ± 13.5 years) with anti-MDA5-ILD were retrospectively reviewed. All patients had clinical diagnoses of dermatomyositis, and 14 patients presented with amyopathic findings. Results Bilateral ground-glass attenuation, air-space consolidation, and reticular shadows were observed in 20 (100%), 15 (75%), and 3 (15%) patients, respectively. The spread of air-space consolidation was 6.0 ± 5.6% (mean ± standard deviation). Univariate analysis revealed that high Krebs von den Lungen-6, high spread of consolidation, low partial pressure of oxygen, and low forced vital capacity were significant predictors for poor survival. The final radiological diagnoses were nonspecific interstitial pneumonia and organising pneumonia (OP) in 2 (10%) and 16 (80%) patients, respectively. Further, 30% of OP patients showed fibrosis. Conclusion The characteristic CT findings of patients with anti-MDA5-ILD were ground-glass attenuation, air-space consolidation, and less reticulation. These CT findings were compatible with those of OP.


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