[Pulmonary involvement in scleroderma assessed with high-resolution computerized tomography and functional tests]

This study was aimed at investigating and analyzing lung involvement in scleroderma patients with different imaging methods, toward a rational diagnostic approach. Twenty-four patients with systemic sclerosis were examined with pulmonary function tests (PFT), spirometry and diffusing capacity for carbon monoxide (DLCO), chest radiography and high-resolution Computed Tomography (HRCT). Abnormal findings were present in 42% of cases on X-ray films and in 71% of cases on HRCT images. PFT was abnormal in the spirometries of 42% of cases and in DLCO tests in 50% of cases. The most common findings at HRCT were the small reticular and the ground-glass patterns. HRCT emerged as the most effective method to evaluate lung involvement in systemic sclerosis. In our series, HRCT allowed possibly curable lung lesions to be differentiated from incurable ones. However, HRCT is suggested in the patients with impaired pulmonary function to allow treatment choice; on the contrary, in the patients with no functional impairment, HRCT adds little information to clinical findings, showing only limited focal lesions.