Interstitial pneumonia in progressive systemic sclerosis: serial high-resolution CT findings with functional...

Area of Science:

• Radiology
• Pulmonology
• Rheumatology

Background:

• Progressive systemic sclerosis (PSS) can lead to interstitial pneumonia, a serious complication affecting lung function.
• Serial high-resolution CT (HRCT) is crucial for monitoring disease progression in PSS-associated interstitial pneumonia.

Purpose of the Study:

• To evaluate serial high-resolution CT findings in patients with PSS and interstitial pneumonia.
• To correlate CT findings with pulmonary function test (PFT) results over time.

Main Methods:

• Retrospective analysis of HRCT scans from 40 patients with PSS and interstitial pneumonia (mean follow-up 39 months).
• Serial PFTs were performed in 17 patients (mean follow-up 40 months).
• Parenchymal abnormalities on HRCT were assessed for pattern and extent, and changes were correlated with PFT changes.

Main Results:

• Initial CT showed ground-glass opacity, irregular linear opacity, nodules, consolidation, and honeycombing.
• Follow-up CT demonstrated significant increases in total disease extent, ground-glass opacity, and honeycombing.
• Pulmonary function tests showed significant decreases in forced vital capacity and forced expiratory volume in 1 second.
• Increased honeycombing extent on CT correlated significantly with decreased diffusing capacity for carbon monoxide (r = -0.411, p = 0.049).

Conclusions:

• In PSS patients with interstitial pneumonia, disease extent, particularly ground-glass opacity and honeycombing, progresses over time as shown by serial HRCT.
• The progression of honeycombing on HRCT is a significant indicator of declining lung function, specifically diffusing capacity for carbon monoxide.