Quantitative interstitial lung disease scores in idiopathic inflammatory myopathies: longitudinal changes and clinical implications.
Quantitative interstitial lung disease scores in idiopathic inflammatory myopathies: longitudinal changes and clinical implications.
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特发性炎症性肌病的间质性肺疾病定量评分：纵向变化和临床意义。
DOI：
10.1093/rheumatology/kead122
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Ha,You-Jung
中科院分区：
文献类型：
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作者：
Yeo,Jina;Yoon,SoonHo;Kim,JuYeon;Lee,JeongSeok;Lee,EunYoung;Goo,JinMo;Pourzand,Lila;Goldin,JonathanG;Kim,Grace-HyunJ;Ha,You-Jung
目的探讨计算机辅助高分辨率CT(HRCT)图像量化评分在特发性炎症性肌肉病(IIMs-ILD)患者中的纵向变化及其临床意义。方法对80例连续两次以上的IIMs-ILD患者的临床资料和HRCT图像进行回顾性分析。定量ILD(QILD)评分(%)是肺纤维化程度、磨玻璃样阴影和蜂窝状改变的总和。结果基线四分位数范围(Δ)得分中位数为28.1%(19.1-43.8)。QILD与用力肺活量(r=−0.349，P=0.002)和一氧化碳弥散量(r=−0.381，P= 0.001)显著相关。对于前两次扫描之间的Δ间质性病变，根据视觉ILD亚型，普通型间质性肺炎(UIP)的QILD加重的发生率高于非UIP(80.0%vs44.4%，P= 0.013)。多变量Logistic回归分析表明，uIP与放射学上的ILD进展显著相关(ΔQILD和GT；2%，P= 0.015)。基线QILD评分较高(28.1%)的患者发生肺移植或死亡的风险较高(P= 0.015)。在连续3次高分辨率CT扫描(n= 41)中，动态观察到4种不同类型的ΔQILD(改善、恶化、凸起和凹陷)。这些可能是IIMS-ILD肺功能、ILD严重程度变化和预后的潜在影像生物标志物。
ObjectivesTo investigate computer-aided quantitative scores from high‐resolution CT (HRCT) images and determine their longitudinal changes and clinical significance in patients with idiopathic inflammatory myopathies (IIMs)-related interstitial lung disease (IIMs-ILD).MethodsThe clinical data and HRCT images of 80 patients with IIMs who underwent serial HRCT scans at least twice were retrospectively analysed. Quantitative ILD (QILD) scores (%) were calculated as the sum of the extent of lung fibrosis, ground-glass opacity, and honeycombing. The individual time-estimated ΔQILD between two consecutive scans was derived using a linear approximation of yearly changes.ResultsThe baseline median QILD (interquartile range) scores in the whole lung were 28.1% (19.1–43.8). The QILD was significantly correlated with forced vital capacity (r=−0.349,P=0.002) and diffusing capacity for carbon monoxide (r=−0.381,P= 0.001). For ΔQILD between the first two scans, according to the visual ILD subtype, QILD aggravation was more frequent in patients with usual interstitial pneumonia (UIP) than non-UIP (80.0%vs44.4%,P= 0.013). Multivariable logistic regression analyses identified UIP was significantly related to radiographic ILD progression (ΔQILD >2%,P= 0.015). Patients with higher baseline QILD scores (>28.1%) had a higher risk of lung transplantation or death (P= 0.015). In the analysis of three serial HRCT scans (n= 41), dynamic ΔQILD with four distinct patterns (improving, worsening, convex and concave) was observed.ConclusionQILD changes in IIMs-ILD were dynamic, and baseline UIP patterns seemed to be related to a longitudinal progression in QILD. These may be potential imaging biomarkers for lung function, changes in ILD severity and prognosis in IIMs-ILD.