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Idiopathic pulmonary fibrosis: progression of honeycombing at thin-section CT
1Department of Radiology, National Kinki chuo Hospital for Chest Disease, Osaka, Japan.
Purpose:
To evaluate the progression of honeycombing at computed tomography (CT) and to determine serial changes in the pattern of disease.
Materials And Methods:
CT scans, obtained in 29 patients with idiopathic pulmonary fibrosis who had undergone at least two serial CT examinations 1-52 months apart, were reviewed. Twelve patients had received no treatment, and 17 patients had received corticosteroids. Initial and follow-up CT scans were evaluated independently and then directly compared with each other.
Results:
Twenty-six of the 29 patients showed progression of honeycombing, which was variable at CT (median, 0.4% [range, 0%-11%] per month) but not significantly different between untreated and treated patients. Areas of ground-glass attenuation on CT scans preceded and were predictive of the development of honeycombing in that location. Corticosteroid treatment reduced areas of ground-glass attenuation, but honeycombing on CT scans was irreversible.
Conclusion:
Low-dose therapy with corticosteroids does not suppress alveolitis sufficiently to prevent continued deterioration of the alveolar structures.