High resolution computed tomography as a predictor of lung histology in systemic sclerosis.

Abstract

Background The relative proportions

Idiopathic Pulmonary Fibrosis and Diffuse Parenchymal Lung Disease: Implications from Initial Experience with18F-FDG PET/CT

“…In all the examined patients with DPLD, there were areas of increased 18 F-FDG pulmonary metabolism, greater than twice background and quoted normal values for lung (19). The distribution of raised 18 F-FDG matched the distribution of the lung parenchymal abnormality. In approximately three fourths of the patients, the area of most intense pulmonary 18 F-FDG uptake corresponded to regions of honeycombing on HRCT.…”

“…The distribution of raised 18 F-FDG matched the distribution of the lung parenchymal abnormality. In approximately three fourths of the patients, the area of most intense pulmonary 18 F-FDG uptake corresponded to regions of honeycombing on HRCT. Such HRCT findings are conventionally believed to be associated with irreversible established fibrotic disease (12,(14)(15)(16)(17)20); hence, to find PET evidence of increased glucose transporter-1-mediated glucose metabolism at these sites is interesting, especially as these areas showed higher metabolism than did those that were ground-glass predominant.…”

“…The radiologist had access to the full HRCT dataset but was given PET/CT images of only the sites of interest identified by the PET reporters. The lung parenchyma in the region of the maximal pulmonary 18 F-FDG uptake was examined for the presence of ground-glass opacity, reticulation, honeycombing, and architectural distortion or traction bronchiectasis, and thus the predominant pattern was determined: ground-glass predominant (14,15), reticulation/honeycombing predominant (15,16), or mixed (17,18). The pattern and distribution of abnormalities on the full HRCT dataset were classified into typical UIP appearances or other (15)(16)(17)(18), and the distribution was classified as diffuse, peripheral, or central in the transverse plane and as upper or lower zone or diffuse in the craniocaudal plane.…”

“…Here, we describe the first, to our knowledge, prospective study of combined 18 F-FDG PET/CT evaluation in IPF and other forms of DPLD. In addition, we sequentially per-formed HRCT on the same PET/CT instrument to gain in vivo insight on lung parenchyma changes at sites of abnormal pulmonary metabolism.…”

Capilaroscopia periungueal pode sugerir atividade de doença pulmonar na esclerose sistêmica

“…No presente estudo, que conta com uma amostra relativamente grande de pacientes com ES, o uso da tomografia computadorizada de alta resolução pulmonar (TCAR) permitiu avaliar a presença, extensão e atividade da doença intersticial pulmonar. Na TCAR, áreas de opacidades em vidro-fosco (OVF) representam regiões de infiltrado inflamatório ativo (41) , podendo subseqüentemente evoluir para faveolamento, que representa fibrose pulmonar irreversível (20) . Utilizando-se métodos de análise multivariada, observou-se que existe associação entre a presença de OVF e a severidade da desvascularização na CPU, mesmo após ajuste para vários potenciais fatores de confusão.…”