CT features of lung disease in patients with systemic scerosis: Comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia

Sujal R. Desai, Srihari Veeraraghavan, David M. Hansell, Ageliki Nikolakopolou, Nicole S.L. Goh, Andrew G. Nicholson, Thomas V. Colby, Christopher P. Denton, Carol M. Black, Roland M. Du Bois, Athol U. Wells

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223 Scopus citations

Abstract

PURPOSE: To evaluate computed tomographic (CT) patterns of lung disease in patients with systemic sclerosis (SSc) and compare them with CT appearance in patients with biopsy-proved idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial pneumonia (NSIP). MATERIALS AND METHODS: The CT features of consecutive patients with SSc (n = 225; male patients, 44; female patients, 181; median age, 47 years; age range, 16-78 years), IPF (n = 40; men, 26; women, 14; median age, 54.5 years; age range, 36-77 years) and NSIP (n = 27; men, 18; women, nine; median age, 53 years; age range, 32-68 years) were quantified separately by two observers. The extent of interstitial lung disease, ground-glass opacification, emphysema, and the coarseness of a reticular pattern were quantified. Group comparisons were made nonparametrically with the Wilcoxon rank sum test. Differences in CT features were identified with multiple logistic regression analysis. RESULTS: The coarseness of fibrosis was similar in patients with SSc and idiopathic NSIP but strikingly different between patients with SSc (median coarseness score, 5.5; range, 0.0-13.3) and IPF (median coarseness score, 8.8; range, 2.5-15.0) (P < .001). The proportion of ground-glass opacification at CT was similar in patients with SSc and idiopathic NSIP but differed significantly between patients with SSc (median proportion, 49.9%, range, 0.0%-100.0%) and IPF (median proportion, 23.5%; range, 0.0%-97.2%) (P < .001). At logistic regression analysis, there were no differences in the CT features between patients with SSc and those with NSIP after controlling for age, disease extent, and the percentage predicted forced vital capacity and carbon monoxide diffusing capacity. CONCLUSION: Interstitial lung disease in patients with SSc is less extensive, less coarse, and characterized by a greater proportion of ground-glass opacification than that in patients with IPF. The CT features of lung disease in patients with SSc closely resemble those in patients with idiopathic NSIP.

Original languageEnglish (US)
Pages (from-to)560-567
Number of pages8
JournalRadiology
Volume232
Issue number2
DOIs
StatePublished - Aug 1 2004

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Keywords

  • Lung, CT
  • Lung, diseases
  • Lung, fibrosis
  • Lung, interstitial disease
  • Pneumonia, nonschedule interstitial and fibrosis
  • Pneumonia, usual interstitial
  • Scleroderma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Desai, S. R., Veeraraghavan, S., Hansell, D. M., Nikolakopolou, A., Goh, N. S. L., Nicholson, A. G., Colby, T. V., Denton, C. P., Black, C. M., Du Bois, R. M., & Wells, A. U. (2004). CT features of lung disease in patients with systemic scerosis: Comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology, 232(2), 560-567. https://doi.org/10.1148/radiol.2322031223