Sarcoidosis with pulmonary fibrosis: CT patterns and correlation with pulmonary function
Sarcoidosis with pulmonary fibrosis: CT patterns and correlation with pulmonary function
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DOI：
10.2214/ajr.174.6.1741751
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发表时间：
2000-06-01
影响因子：
5
通讯作者：
Brauner, MW
中科院分区：
文献类型：
--
作者：
Abehsera, M;Valeyre, D;Brauner, MW
目标。本研究的目的是确定结节病患者肺纤维化的CT模式，并将这些模式与肺功能检查联系起来。材料和方法。我们对80例结节病患者的CT扫描和胸片上的纤维化改变进行了回顾性分析。三种主要的CT表现：支气管扭曲（n = 38,47%），主要为中央型；蜂窝状（n = 23, 29%），主要分布在外围；线性（n = 19, 24%），以弥漫性为主。在大多数情况下，观察者之间的良好一致（kappa = 0.87）可以清楚地识别出一种模式。结节与线状（87%）和扭曲型（71%）显著相关，但与蜂窝状（35%）无关。蜂窝型最常与一氧化碳肺弥散能力受限和降低有关。支气管扭曲患者的呼气气流速率较低。线性模式通常与最小的功能损害相关。CT可能是确定纤维化肺结节病患者亚群的有用工具。CT显示三种主要模式，可能反映不同肺功能损伤的肺纤维化病变的不同分布。由结节性病变提示的活动性肺病变的持续存在通常与线状和扭曲的模式有关。
OBJECTIVE. The purpose of our study was to identify CT patterns of pulmonary fibrosis in patients with sarcoidosis and to correlate these patterns with pulmonary function tests.MATERIALS AND METHODS. We conducted a retrospective review of CT scans of 80 patients with proven sarcoidosis and evidence of fibrotic changes on chest radiographs.RESULTS. Three main CT patterns were identified: bronchial distortion (n = 38, 47%), mainly central; honeycombing (n = 23, 29%), mainly peripheral; and linear (n = 19, 24%), mainly diffuse. In most cases, a pattern was clearly identified as shown by the good agreement between observers (kappa = 0.87). Nodules were significantly associated with the linear (87%) and distorted (71%) patterns, but not with the honeycomb pattern (35%). The honeycomb pattern was most often associated with restriction and decreased lung diffusing capacity for carbon monoxide. Patients with bronchial distortion had lower expiratory airflow rates. The linear pattern was generally associated with the least functional impairment.CONCLUSION. CT may be a useful tool for defining subgroups of patients with fibrotic pulmonary sarcoidosis. CT reveals three main patterns that may reflect different distributions of fibrotic lesions in the lung with different functional pulmonary impairments. The persistence of active pulmonary lesions suggested by the presence of nodular lesions was often associated with linear and distorted patterns.