scholarly journals Quantitative High-resolution Computed tomography Analysis of Antisynthetase Syndrome with Interstitial Pneumonia

2021 ◽  
Author(s):  
Xueren Li ◽  
Shouchun Peng ◽  
Qi Wu ◽  
Huarui Zhang ◽  
Na Feng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Pneumonia ◽  
Reference Value ◽  
Hounsfield Unit ◽  
Antisynthetase Syndrome ◽  
High Resolution Computed Tomography ◽  
Volume Weight ◽  
Hrct Patterns ◽  
Attenuation Values

Abstract Background Non-specific interstitial pneumonia (NSIP) combined with organizing pneumonia (OP) pattern has been confirmed in pathology or radiology. This study is to analyze the correlation between high-resolution computed tomography (HRCT) quantitative indexes (QI) and pulmonary function test parameters (PFTs), and compare differences of HRCT patterns in Antisynthetase Syndrome with interstitial pneumonia (ASS-IP).Methods Data of ASS-IP patients admitted to respiratory department of Ping Jin hospital from January 2014 to December 2019 were retrospectively reviewed.Results 21 ASS-IP patients were enrolled in this study and 3 patients were NSIP, 9 patients were OP and 8 patients were NSIP overlap OP (NSIP/OP) pattern. (1) Volume, Weight percentages of the extracted whole lung volume with attenuation values (V%, W %) and mean lung attenuation (MLA) of non-aerated area is 5.69%, 16.43% and -11.76 Hounsfield unit (Hu). Total MLA of attenuation values(MLAtotal) is -678.97 Hu.(2)FVC and MLA of poorly aerated（r=0.58,P=0.048）, FEV1 and MLA（r=0.79,P=0.001）of poorly aerated, FEV1/FVC（r=0.23,P=0.01） and MLA of normally lung aerated, have linear correlation .(3) DLCO (P=0.049), volume of poorly aerated (Vfibrosis%,P =0.03), and weight of hyper inflated (Whyper%,P=0.02) percentages, and MLAtotal (P=0.01) have significant statistic differences between patients with NSIP/OP or OP patterns, but the therapy improvement time(P=0.41) had no difference. Conclusions QI of HRCT has a good correlation with PFTs and partly reference value to pathological classification of ASS-IP. NSIP/OP may be a common pattern in ASS-IP, fibrosis severity of which is more severe than OP.

scholarly journals AB0605 CLINICAL PROFILE AND CHEST HIGH-RESOLUTION COMPUTED TOMOGRAPHY (HRCT) FINDINGS IN PATIENTS WITH CONNECTIVE TISSUE DISEASES AND INTERSTITIAL LUNG DISEASE: EXPERIENCE OF A SINGLE REFERENCE RHEUMATOLOGY CENTER

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1598.2-1599
Author(s):  
I. Rusu ◽  
L. Muntean ◽  
M. M. Tamas ◽  
I. Felea ◽  
L. Damian ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systemic Sclerosis ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Connective Tissue Diseases ◽  
High Resolution Computed Tomography ◽  
Hrct Patterns

Background:Interstitial lung disease (ILD) is a common manifestation of connective tissue diseases (CTDs), and is associated with significant morbidity and mortality. Chest high-resolution computed tomography (HRCT) play an important role in the diagnosis of ILD and may provide prognostic information.Objectives:We aimed to characterize the clinical profile and chest HRCT abnormalities and patterns of patients diagnosed with CTDs and ILD.Methods:In this retrospective, observational study we included 80 consecutive patients with CTDs and ILD referred to a tertiary rheumatology center between 2015 and 2019. From hospital charts we collected clinical data, immunologic profile, chest HRCT findings. HRCT patterns were defined according to new international recommendations.Results:Out of 80 patients, 64 (80%) were women, with a mean age of 55 years old. The most common CTD associated with ILD was systemic sclerosis (38.8%), followed by polymyositis (22.5%) and rheumatoid arthritis (18.8%). The majority of patients had dyspnea on exertion (71.3%), bibasilar inspiratory crackles were present in 56.3% patients and 10% had clubbing fingers. Antinuclear antibodies (ANA) were present in 78.8% patients, and the most frequently detected autoantibodies against extractable nuclear antigen were anti-Scl 70 (28.8%), followed by anti-SSA (anti-Ro, 17.5%), anti-Ro52 (11.3%) and anti-Jo (7.5%). Intravenous cyclophosphamide therapy for 6-12 months was used in 35% of patients, while 5% of patients were treated with mycophenolate mofetil.The most frequent HRCT abnormalities were reticular abnormalities and ground glass opacity. Non-specific interstitial pneumonia (NSIP) was identified in 46.3% CTDs patients. A pattern suggestive of usual interstitial pneumonia (UIP) was present in 32.5% patients, mainly in patients with systemic sclerosis. In 21.3% patients the HRCT showed reticulo-nodular pattern, micronodules and other abnormalities, not diagnostic for UIP or NSIP pattern.Conclusion:Nonspecific interstitial pneumonia (NSIP) is the most common HRCT pattern associated with CTDs. Further prospective longitudinal studies are needed in order to determine the clinical and prognostic significance of various HRCT patterns encountered in CTD-associated ILD and for better patient management.References:[1]Ohno Y, Koyama H, Yoshikaua T, Seki S. State-of-the-Art Imaging of the Lung for Connective Tissue Disease (CTD). Curr Rheumatol Rep. 2015;17(12):69.[2]Walsh SLF, Devaraj A, Enghelmeyer JI, Kishi K, Silva RS, Patel N, et al. Role of imaging in progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018;27(150)Disclosure of Interests:None declared

Development and evaluation of a computer-based decision support system for diffuse lung diseases at high-resolution computed tomography

2021 ◽  
pp. 028418512199579
Author(s):  
Simon S Martin ◽  
Delina Kolaneci ◽  
Julian L Wichmann ◽  
Lukas Lenga ◽  
Doris Leithner ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Decision Support ◽  
High Resolution ◽  
Lung Diseases ◽  
Differential Diagnoses ◽  
High Resolution Computed Tomography ◽  
Computer Based ◽  
Diffuse Lung Diseases ◽  
Hrct Patterns ◽  
Diffuse Lung

Background High-resolution computed tomography (HRCT) is essential in narrowing the possible differential diagnoses of diffuse and interstitial lung diseases. Purpose To investigate the value of a novel computer-based decision support system (CDSS) for facilitating diagnosis of diffuse lung diseases at HRCT. Material and Methods A CDSS was developed that includes about 100 different illustrations of the most common HRCT signs and patterns and describes the corresponding pathologies in detail. The logical set-up of the software facilitates a structured evaluation. By selecting one or more CT patterns, the program generates a ranked list of the most likely differential diagnoses. Three independent and blinded radiology residents initially evaluated 40 cases with different lung diseases alone; after at least 12 weeks, observers re-evaluated all cases using the CDSS. Results In 40 patients, a total of 113 HRCT patterns were evaluated. The percentage of correctly classified patterns was higher with CDSS (96.8%) compared to assessment without CDSS (90.3%; P < 0.01). Moreover, the percentage of correct diagnosis (81.7% vs. 64.2%) and differential diagnoses (89.2% vs. 38.3%) were superior with CDSS compared to evaluation without CDSS (both P < 0.01). Conclusion Addition of a CDSS using a structured approach providing explanations of typical HRCT patterns and graphical illustrations significantly improved the performance of trainees in characterizing and correctly identifying diffuse lung diseases.

scholarly journals High-resolution computed tomography as a non-invasive imaging biomarker for interstitial lung diseases: a tertiary center study

2021 ◽  
Vol 8 (2) ◽  
pp. 207
Author(s):  
Krishna Pratap Singh Senger ◽  
Ankita Singh
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Interstitial Lung Diseases ◽  
Imaging Biomarker ◽  
Histopathological Diagnosis ◽  
High Resolution Computed Tomography ◽  
Non Invasive ◽  
Tertiary Center

Background: Interstitial lung diseases (ILD) are a heterogeneous group of non-neoplastic disorders resulting from damage to the lung parenchyma by varying patterns of inflammation and fibrosis. With high-resolution computed tomography (HRCT) the pattern of lung damage can be mapped accurately which may help to identify specific ILD.Methods: 65 diagnosed cases of ILD by HRCT who were admitted to a tertiary care chest hospital, formed the study group. All these patients also underwent histopathological confirmation as per hospital protocol. The study was done over a period from August 2016 to July 2019. Clinical details, chest x-ray, HRCT and histopathological data was collected and analysed using 2x2 table for detecting sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV).Results: For diagnosing ILD like acute interstitial pneumonia (AIP), LIP and RB ILD the HRCT fared equally well in diagnostic utility as compared to histopathological examination. But in certain conditions like non-specific interstitial pneumonia (NSIP) the HRCT performed poorly in terms of PPV as compared to gold standard histopathology. In Bronchiolitis obliterans organizing pneumonia (BOOP) and usual interstitial pneumonia (UIP) again the HRCT performed fairly well as compared to gold standard.Conclusions: HRCT shows good correlation with histopathological diagnosis in identifying a various subtype of ILD and may thus serve a useful non-invasive, imaging biomarker not only for diagnosing a particular ILD but for prognostication and response to treatment.

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