New radiological symptoms in chest HRCT in patients with interstitial lung disease in the course of systemic sclerosis and RA
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Zakład Radiologii Lekarskiej CSK MON WIM w Warszawie; kierownik dr n. med. Artur Maliborski
Klinika Chorób Wewnętrznych i Reumatologii CSK MON WIM w Warszawie; kierownik: prof. dr hab. n. med. Witold Tłustochowicz
Marta Kania‑Pudło
Submission date: 2020-02-28
Publication date: 2020-04-06
LW 2020;98(2):142–149
Objective. In systemic connective tissue diseases such as rheumatoid arthritis and systemic sclerosis, many organs, including the lungs, are affected. The aim of the study was to retrospectively compare the incidence of radiological manifestations of pulmonary fibrosis: the exuberant honeycombing sign, the straight‑edge sign and the four corners sign in chest HRCT, as well as bronchiectases and esophageal dilatation in patients with systemic sclerosis (SS‑ILD) and rheumatoid arthritis (RA‑ILD). Material and method. Seventy‑seven HRCT studies of patients with SS‑ILD and ninety‑six with RA‑ILD were evaluated for lung fibrosis using a method developed by Warrick and classified into three groups of disease severity. The incidence of the exuberant honeycombing sign, the straight‑edge sign and the four corners sign and bronchiectases in specific subgroups of lung fibrosis severity and incidence of esophageal dilatation were determined. Results. Significantly more advanced lung fibrosis was found in patients with SS‑ILD compared to patients with RA‑ILD (13.33 ±6.23 vs.9.80 ±6,56, p = 0.0004). The frequency of the four corners sign and the combined frequency of the exuberant honeycombing sign, the straight edge sign and the four corners sign were significantly higher in the SS‑ILD group than RA‑ILD (9 [11.68%]vs. 1 [1.04%], respectively, p = 0.003 and 12 [15.58%] vs.6 [6.25%], p = 0.046). These diseases differed significantly in the incidence of bronchiectases (51 patients with SS‑ILD [66.23%] and 22 patients with RA‑ILD [22.91%], p <1 × 10‑6) and esophageal dilatation (53 patients with SS‑ILD [68.83%] and 14 patients with RA‑ILD [14.58%], p <1 × 10‑6). Conclusions. The low incidence of the all assessed symptoms, despite significant differences, do not allow to differentiate the type of connective tissue diseases responsible for pulmonary fibrosis based on chest HRCT examination only.
No conflicts of interest were declared.