Changes seen on computed tomography of the chest in mildly symptomatic adult patients with sickle cell disease

Alves, Úrsula David; Lopes, Agnaldo José; Maioli, Maria Christina Paixão; Soares, Andréa; Melo, Pedro Lopes de; Mogami, Roberto

doi:10.1590/0100-3984.2015.0111

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…In our sample, less than 1/3 of the patients had a reduced FEV 1 /FVC and/or increased RV/TLC; the latter parameter is compatible with air trapping. Although the mechanism is still poorly understood, several hypotheses have been raised to explain the obstructive pattern in patients with SCA, including chronic airway inflammation, bronchial hyper-reactivity, associated asthma, and an increased pulmonary capillary volume ( 3 , 33 ). Interestingly, almost 40% of our population had a high CV/VC ratio in N 2 SBW, which was compatible with small airway disease.…”

Section: Discussionmentioning

confidence: 99%

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Lopes

Marinho

Alves

et al. 2017

Braz J Med Biol Res

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Sickle cell anemia (SCA) causes dysfunction of multiple organs, with pulmonary involvement as a major cause of mortality. Recently, there has been growing interest in the nitrogen single-breath washout (N2SBW) test, which is able to detect ventilation heterogeneity and small airway disease when the results of other pulmonary function tests (PFTs) are still normal. Thus, the objectives of the present study were to assess the heterogeneity in the ventilation distribution in adults with SCA and to determine the association between the ventilation distribution and the clinical, cardiovascular, and radiological findings. This cross-sectional study included 38 adults with SCA who underwent PFTs, echocardiography, computed tomography (CT), and 6-min walk test. To evaluate the ventilation heterogeneity, the patients were categorized according to the phase III slope of the N2SBW (SIIIN2). Compared with adults with lower SIIIN2 values, adults with higher SIIIN2 values showed lower hemoglobin levels (P=0.048), a history of acute chest syndrome (P=0.001), an elevated tricuspid regurgitation velocity (P=0.039), predominance of a reticular pattern in the CT (P=0.002), a shorter 6-min walking distance (6MWD) (P=0.002), and lower peripheral oxygen saturation (SpO2) after exercise (P=0.03). SIIIN2 values correlated significantly with hemoglobin (rs=-0.344; P=0.034), forced vital capacity (rs=-0.671; P<0.0001), diffusing capacity for carbon monoxide (rs=-0.376; P=0.019), 6MWD (rs=-0.554; P=0.0003), and SpO2 after exercise (P=0.040). Heterogeneity in the ventilation distribution is one of the most common pulmonary dysfunctions in adults with SCA. Moreover, relationships exist between ventilation heterogeneity, worsening of pulmonary structural damage, and reduced tolerance for exercise.

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Section: Discussionmentioning

confidence: 99%

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Lopes

Marinho

Alves

et al. 2017

Braz J Med Biol Res

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“…Given the innumerable clinical, radiological, and pathological aspects, as well as the constant need to analyze the course of IIPs, it is essential that the diagnosis and follow-up of these diseases be conducted within a multidisciplinary scenario in which the radiologist assumes a fundamental role. High-resolution computed tomography of the chest has been the subject of recent publications in the radiology literature of Brazil ( 1 - 7 ) . The integrated approach notwithstanding, the final classification and definitive diagnosis might not be achieved in all cases.…”

Section: Introductionmentioning

confidence: 99%

Idiopathic interstitial pneumonias: review of the latest American Thoracic Society/European Respiratory Society classification

et al. 2018

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The diagnosis of idiopathic interstitial pneumonias (IIPs) involves a multidisciplinary scenario in which the radiologist assumes a key role. The latest (2013) update of the IIP classification by the American Thoracic Society/European Respiratory Society proposed some important changes to the original classification of 2002. The novelties include the addition of a new disease (idiopathic pleuroparenchymal fibroelastosis) and the subdivision of the IIPs into four main groups: chronic fibrosing IIPs (idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia); smoking-related IIPs (desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung disease); acute or subacute IIPs (cryptogenic organizing pneumonia and acute interstitial pneumonia); rare IIPs (lymphoid interstitial pneumonia and idiopathic pleuroparenchymal fibroelastosis); and the so-called “unclassifiable” IIPs. In this study, we review the main clinical, tomographic, and pathological characteristics of each IIP.

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“…The use of HRCT scans to evaluate individuals with lung diseases has been the reason for a series of recent publications in the radiology literature of Brazil ( 24 - 32 ) . The results of the present study demonstrate that, in the HRCT evaluation of patients with bronchiectasis, interobserver and intraobserver agreement was generally moderate for each tomography finding in isolation.…”

Section: Discussionmentioning

confidence: 99%

Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography

et al. 2017

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ObjectiveTo evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT).Materials and MethodsThe HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists, who used a scoring system to grade the findings. Kappa (κ) values and overall agreement were calculated.ResultsFor the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (κ = 0.45 and κ = 0.43, respectively), as was the intraobserver agreement (κ = 0.54 and κ = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and κ = 0.39 for intraobserver agreement) and for peripheral distribution (κ = 0.34 and κ = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peribronchial thickening (κ = 0.21 and κ = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (κ = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and κ = 0.24, respectively), and cysts/bullae (κ = 0.47 and κ = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intraclass correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively).ConclusionIn the interpretation of HRCT findings of bronchiectasis, radiologist agreement appears to be fair. In our final analysis of the findings using the proposed score, we observed excellent interobserver and intraobserver agreement.

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Changes seen on computed tomography of the chest in mildly symptomatic adult patients with sickle cell disease

Cited by 7 publications

References 36 publications

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Relationship between ventilation heterogeneity and exercise intolerance in adults with sickle cell anemia

Idiopathic interstitial pneumonias: review of the latest American Thoracic Society/European Respiratory Society classification

Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography

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