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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
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Ventilation distribution and small airway function in patients with systemic sclerosis
B R A Silva1, R Rufino2, C H Costa2
1Laboratory of Respiratory Physiology, State University of Rio de Janeiro, and Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Revista Portuguesa De Pneumologia
|March 5, 2017
Summary
The nitrogen single-breath washout (N2SBW) test effectively detects ventilation heterogeneity in systemic sclerosis (SSc) patients, correlating with lung function and CT findings. This method aids in diagnosing SSc-related lung disease, even with normal traditional pulmonary function tests.
Area of Science:
- Pulmonary Medicine
- Radiology
- Diagnostic Testing
Background:
- Traditional pulmonary function tests (PFTs) are crucial for managing systemic sclerosis (SSc).
- However, many SSc patients with pulmonary disease evident on CT scans exhibit normal PFTs, highlighting a diagnostic gap.
Purpose of the Study:
- To assess the efficacy of the nitrogen single-breath washout (N2SBW) test in diagnosing SSc.
- To correlate N2SBW parameters with established PFT indices, clinical data, and CT findings in SSc patients.
Main Methods:
- A cross-sectional study involving 52 consecutive SSc patients.
- Patients underwent spirometry, body plethysmography, diffusing capacity for carbon monoxide (DLCO) analysis, respiratory muscle strength testing, N2SBW testing, and CT analysis.
Main Results:
- The N2SBW test revealed ventilation heterogeneity in a significant portion of SSc patients.
- Phase III slope (Phase III slopeN2SBW) and closing volume/vital capacity (CV/VC) parameters showed significant correlations with FVC and DLCO, as well as with CT patterns like traction bronchiectasis and honeycombing.
Conclusions:
- Ventilation heterogeneity is common in SSc patients and is linked to restrictive lung damage, impaired diffusion, and specific CT findings.
- The N2SBW test is a valuable tool for identifying small airway disease in approximately one-third of SSc patients, complementing traditional PFTs.
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