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Updated: May 23, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Chronic hypersensitivity pneumonitis: high resolution computed tomography patterns and pulmonary function indices as
Simon L F Walsh1, Nicola Sverzellati, Anand Devaraj
1Department of Radiology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. slfwalsh@gmail.com
High-resolution computed tomography (HRCT) patterns, especially traction bronchiectasis and honeycombing, are better than pulmonary function tests (PFTs) for predicting survival in chronic fibrotic hypersensitivity pneumonitis (CHP). These HRCT findings offer crucial prognostic information for CHP patients.
Area of Science:
- Pulmonary Medicine
- Radiology
- Medical Prognostics
Background:
- Chronic fibrotic hypersensitivity pneumonitis (CHP) is a progressive interstitial lung disease.
- Accurate prognostic markers are essential for managing CHP patients.
- High-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) are commonly used in assessing lung diseases.
Purpose of the Study:
- To evaluate the efficacy of HRCT patterns and PFTs in predicting prognosis for patients with CHP.
- To determine which imaging or functional parameters are superior for mortality prediction in CHP.
Main Methods:
- Retrospective analysis of 92 patients with CHP, including their medical records, PFTs (FEV1, FVC, DLco), and HRCT scans.
- HRCT scans were scored for disease extent and specific patterns like ground-glass opacification, reticulation, honeycombing, and traction bronchiectasis.
- Cox proportional hazards regression models were used to assess the prognostic value of HRCT patterns and PFT variables.
Main Results:
- Mortality was observed in 42 patients during the study period.
- The severity of traction bronchiectasis on HRCT was the strongest predictor of mortality (HR 1.10, P < 0.001).
- Increasing global interstitial disease extent, microcystic honeycombing, and macrocystic honeycombing also independently predicted mortality, whereas no individual PFT variable was predictive after accounting for HRCT findings.
Conclusions:
- HRCT patterns, particularly traction bronchiectasis and honeycombing, are superior to PFTs for predicting mortality in CHP.
- The severity of traction bronchiectasis is a significant independent predictor of poor survival in CHP.
- HRCT provides more robust prognostic information than PFTs for patients diagnosed with CHP.
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