CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia.

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). 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. 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%-97.2%) (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. 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.

Desai SR ，Veeraraghavan S ，Hansell DM ，Nikolakopolou A ，Goh NS ，Nicholson AG ，Colby TV ，Denton CP ，Black CM ，du Bois RM ，Wells AU ... -  《RADIOLOGY》

Nonspecific interstitial pneumonia and usual interstitial pneumonia: comparative appearances at and diagnostic accuracy of thin-section CT.

MacDonald SL ，Rubens MB ，Hansell DM ，Copley SJ ，Desai SR ，du Bois RM ，Nicholson AG ，Colby TV ，Wells AU ... -  《RADIOLOGY》

Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features.

Copley SJ ，Wells AU ，Sivakumaran P ，Rubens MB ，Lee YC ，Desai SR ，MacDonald SL ，Thompson RI ，Colby TV ，Nicholson AG ，du Bois RM ，Musk AW ，Hansell DM ... -  《RADIOLOGY》

Nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis: changes in pattern and distribution of disease over time.

Silva CI ，Müller NL ，Hansell DM ，Lee KS ，Nicholson AG ，Wells AU ... -  《-》

Usual interstitial pneumonia and chronic idiopathic interstitial pneumonia: analysis of CT appearance in 92 patients.

To retrospectively analyze computed tomographic (CT) findings of chronic idiopathic interstitial pneumonia (IIP) and to determine which findings are most helpful for distinguishing IIP from usual interstitial pneumonia (UIP) with univariate and multivariate analyses. Institutional review board approval and informed consent were not required for this retrospective review of patient records and images. Two observers working independently and without knowledge of the diagnosis evaluated the extent and distribution of various thin-section CT findings (ground-glass opacity, consolidation, reticulation, and honeycombing) in 92 patients (51 men, 41 women; mean age, 56 years; age range, 29-81 years) with a histologic diagnosis of UIP (n = 20), cellular nonspecific interstitial pneumonia (NSIP) (n = 16), fibrotic NSIP (n = 16), respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) (n = 11), desquamative interstitial pneumonia (DIP) (n = 15), or lymphoid interstitial pneumonia (LIP) (n = 14). Observers used univariate and multivariate statistical analyses to compare their findings with the extent and distribution of UIP. Observers made the correct diagnosis in 145 (79%) of 184 readings. Multivariate logistic regression analysis showed that the independent findings that distinguished UIP from cellular NSIP were the extent of honeycombing and the most proximal bronchus with traction bronchiectasis (odds ratio, 5.16 and 0.37, respectively); the finding that distinguished UIP from fibrotic NSIP was the extent of honeycombing (odds ratio, 2.10). CT features that distinguished UIP from RB-ILD and DIP included extent of ground-glass opacity (odds ratio, 0.76), thickening of bronchovascular bundles (odds ratio, 1.58), the most proximal bronchus with traction bronchiectasis (odds ratio, 0.22), and the number of segments with traction bronchiectasis (odds ratio, 3.64). UIP has a characteristic appearance that usually facilitates distinction from other types of chronic IIPs at thin-section CT. The most useful finding when differentiating UIP from NSIP was the extent of honeycombing.

Sumikawa H ，Johkoh T ，Ichikado K ，Taniguchi H ，Kondoh Y ，Fujimoto K ，Tateishi U ，Hiramatsu T ，Inoue A ，Natsag J ，Ikemoto M ，Mihara N ，Honda O ，Tomiyama N ，Hamada S ，Nakamura H ，Müller NL ... -  《RADIOLOGY》