CT蜂和引力支气管切除的程度独立地预测了纤维化间歇性肺部疾病亚型的生存率
Daniel-Costin Marinescu1, Cameron J Hague1, Nestor L Muller1
1From the Department of Medicine, University of British Columbia, Vancouver, Canada (D.C.M., G.C.G., N.K., A.W.W., B.Z., C.J.R.); Centre for Lung Health, Vancouver General Hospital, 2775 Laurel St, 7th Fl, Vancouver, BC, Canada V5Z 1M9 (D.C.M., N.K.); Department of Radiology, University of British Columbia, Vancouver, Canada (C.J.H., N.L.M., A.M.B., J.E., J.L., J. Mayo, T.S.); Department of Radiology, St James' Hospital, Dublin, Ireland (D.M.); Department of Pathology, University of British Columbia, Vancouver, Canada (A.C., J.L.W.); Department of Radiology, McMaster University, Hamilton, Canada (A.A.A., E.H., V.T.); Department of Radiology, University of Montreal, Montreal, Canada (P.B.); Department of Medicine, McMaster University, Hamilton, Canada (G.C., N.H., M.K., S.M., C.S.); Department of Medicine, University of Toronto, Toronto, Canada (J.H.F., L.L.S., S.S., K.S.); Department of Medicine, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Canada (C.D., H.M., J. Morisset); Department of Radiology, University of Calgary, Calgary, Canada (T.E., Z.G., J.H.); Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada (D.F., G.K.); Department of Medicine, University of Calgary, Calgary, Canada (A.G.O., K.A.J.); Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, Pa (G.C.G.); Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, Canada (D.C.M., G.C.G., A.W.W., B.Z., C.J.R.); Department of Medicine, University of Saskatchewan, Saskatoon, Canada (S.L., V.M.); and Department of Medical Imaging, University of Toronto, Toronto, Canada (M.M.).
放射性特征,如蜂和引支气管切除,可以预测间歇性肺病 (ILD) 的存活率,独立于临床因素. 当考虑纤维化程度时,特定的模式失去了预后价值.
科学领域:
- 放射学 放射学是一门学科.
- 肺部病理学 肺部病理学
- 医疗成像医学成像
背景情况:
- 间歇性肺病 (ILD) 中放射性特征的预后值是可变的,特别是在异常性肺纤维化中.
- 个人放射学特征与指导方针定义的模式在预测ILD结果中的比较重要性仍然不清楚.
研究的目的:
- 为了识别与所有ILD亚型的无移植生存独立相关的放射性特征,超出临床因素.
- 确定个人放射性特征或指南定义的模式是否对ILD的预后更为关键.
主要方法:
- 对未来加拿大肺纤维化注册的二次分析,包括1593名ILD患者.
- 在薄截面CT图像上的放射性特征的量化和指导方针定义的通常间歇性肺炎 (UIP) 和纤维过敏性肺炎 (fHP) 模式的分配.
- 多变量考克斯分析和嵌套模型来评估与无移植生存的关联,并比较特征与模式的重要性.
主要成果:
- 四个放射学特征独立预测了无移植生存率:蜂巢的程度,引支气管的程度,肺动脉直径和下节省的存在.
- 当将四种放射性特征纳入模型时,指南定义的UIP和fHP模式与生存没有独立相关.
- 四个确定的放射学特征中的每一个都保留了其预后价值,这表明它们比单独的模式分类更为关键.
结论:
- 纤维化的程度,通过蜂和引支气管病变等特征来表明,是ILD中较差结果的重要预测因素,独立于临床因素.
- 指南定义的模式 (UIP,fHP) 可能作为纤维化程度的替代品,解释它们以前观察到的与死亡率的关联.
- 放射性特征,特别是纤维化程度,提供独立的预后信息,对于管理各种ILD亚型患者至关重要.
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