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Pulmonary fibrosis and emphysema: Is the emphysema type associated with the pattern of fibrosis?

World Journal of Radiology 2015年第9期7卷 294-305页

作者： Anastasia Oikonomou Paraskevi Mintzopoulou Argyris Tzouvelekis Petros Zezos george zacharis Anastasios Koutsopoulos Demosthenes Bouros Panos Prassopoulos Department of Radiology Democritus University of Thrace Department of Medical Imaging Sunnybrook Health Sciences Centre Department of Pneumonology Democritus University of Thrace Yale School of Medicine Department of Internal Medicine Section of Pulmonary Critical Care and Sleep Medicine Department of Endoscopic Unit Democritus University of Thrace Department of Internal Medicine Division of Gastroenterology Sunnybrook Health Sciences Centre Department of Pathology Democritus University of Thrace Department of Pathology University of Herakleion

AIM: To investigate whether the predominant emphysema type is associated with the high resolution computed tomography(HRCT) pattern of fibrosis in combined pulmonary fibrosis and emphysema(CPFE).METHODS: Fifty-three smokers with upper lobe emphysema and lower lobe pulmonary fibrosis on- HRCT-were retrospectively evaluated. Patients were stratified into 3 groups according to the predominant type of emphysema: Centrilobular(CLE), paraseptal(PSE), CLE = PSE. Patients were also stratified into 3 other groups according to the predominant type of fibrosis on HRCT: Typical usual interstitial pneumonia(UIP), probable UIP and nonspecific interstitial pneumonia(NSIP). HRCTs were scored at 5 predetermined levels for the coarseness of fibrosis(Coarseness), extent of emphysema(emphysema), extent of interstitial lung disease(Tot Ext ILD), extent of reticular pattern not otherwise specified(Ret NOS), extent of ground glass opacity with traction bronchiectasis(extG GOBx), extent of pure ground glass opacity and extent of honeycombing. HRCT mean scores, pulmonary function tests, diffusion capacity(DLCO) and systolic pulmonary arterial pressure were compared among the groups.RESULTS: The predominant type of emphysema was strongly correlated with the predominant type of fibrosis. The centrilobular emphysema group exhibited a significantly higher extent of emphysema(P < 0.001) and a lower extent of interstitial lung disease(P < 0.002), reticular pattern not otherwise specified(P < 0.023), extent of ground glass opacity with traction bronchiectasis(P < 0.002), extent of honeycombing(P < 0.001) and coarseness of fibrosis(P < 0.001) than the paraseptal group. The NSIP group exhibited a significantly higher extent of emphysema(P < 0.05), total lung capacity(P < 0.01) and diffusion capacity(DLCO)(P < 0.05) than the typical UIP group. The typical UIP group exhibited a significantly higher extent of interstitial lung disease, extent of reticular pattern not otherwise specified, extent of ground glass opacity with traction bronchiectasis, e

关键词： Emphysema Pulmonary fibrosis High resolution compu

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