CT features of lung disease in patients with systemic sclerosis: Comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia
CT features of lung disease in patients with systemic sclerosis: Comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia
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DOI：
10.1148/radiol.2322031223
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发表时间：
2004-08-01
期刊：
影响因子：
19.7
通讯作者：
Wells, AU
中科院分区：
文献类型：
--
作者：
Desai, SR;Veeraraghavan, S;Wells, AU
目的：评价系统性硬化症(SSC)患者肺部疾病的CT表现，并与经活检证实的特发性肺纤维化(IPF)和特发性非特异性间质性肺炎(NSIP)患者的CT表现进行比较。材料和方法：连续收治的SSC患者(225例；男性44例；女性181例；中位年龄47岁；年龄16-78岁)、IPF(40例；男性26例；女性14例；中位年龄54.5岁；年龄范围36-77岁)和NSIP(27例；男性18例；女性，9岁；中位年龄，53岁；年龄范围，32-68岁)由两名观察员分别量化。对间质性肺疾病、毛玻璃样混浊、肺气肿和网状结构的粗糙度进行了量化。组间比较用Wilcoxon秩和检验进行非参数检验。结果：SSc患者和特发性NSIP患者的纤维化程度相似，但SSC患者和IPF患者(中位粗糙评分，8.8；范围，2.5-15.0)显著不同(P<；.001)。SSc患者和特发性NSIP患者CT上磨玻璃样混浊的比例相似，但SSc患者(中位数比例，49.9%；范围，0.0%~100.0%)和特发性肺间质纤维化患者(中位数比例，23.5%；范围，0.0%~97.20/0)之间有显著差异(P<；.001)。在Logistic回归分析中，在控制了年龄、疾病范围以及预测用力肺活量和一氧化碳弥散能力的百分比后，SSc和NSIP患者的CT特征没有差异。结论：SSc患者的间质性肺疾病比IPF患者范围更广、更粗糙，以磨玻璃样阴影的比例更大。SSc患者肺部病变的CT表现与特发性NSIP患者极为相似。(C)RSNA，2004年。
PURPOSE: To evaluate computed tomographic (CT) patterns of lung disease in patients with systemic sclerosis (SSc) and compare them with CT appearance in patients with biopsy-proved idiopathic pulmonary fibrosis (IPF) and idiopathic nonspecific interstitial pneumonia (NSIP).MATERIALS AND METHODS: The CT features of consecutive patients with SSc (n = 225; male patients, 44; female patients, 181; median age, 47 years; age range, 16-78 years), IPF (n = 40; men, 26; women, 14; median age, 54.5 years; age range, 36-77 years) and NSIP (n = 27; men, 18; women, nine; median age, 53 years; age range, 32-68 years) were quantified separately by two observers. The extent of interstitial lung disease, ground-glass opacification, emphysema, and the coarseness of a reticular pattern were quantified. Group comparisons were made nonparametrically with the Wilcoxon rank sum test. Differences in CT features were identified with multiple logistic regression analysis.RESULTS: The coarseness of fibrosis was similar in patients with SSc and idiopathic NSIP but strikingly different between patients with SSc (median coarseness score, 5.5; range, 0.0-13.3) and IPF (median coarseness score, 8.8; range, 2.5-15.0) (P < .001). The proportion of ground-glass opacification at CT was similar in patients with SSc and idiopathic NSIP but differed significantly between patients with SSc (median proportion, 49.9%; range, 0.0%-100.0%) and IPF (median proportion, 23.5%; range, 0.0%-97.20/0) (P < .001). At logistic regression analysis, there were no differences in the CT features between patients with SSc and those with NSIP after controlling for age, disease extent, and the percentage predicted forced vital capacity and carbon monoxide diffusing capacity.CONCLUSION: Interstitial lung disease in patients with SSc is less extensive, less coarse, and characterized by a greater proportion of ground-glass opacification than that in patients with IPF. The CT features of lung disease in patients with SSc closely resemble those in patients with idiopathic NSIP. (C) RSNA, 2004.