High resolution computed tomography in fibrosing alveolitis associated with systemic sclerosis.
OBJECTIVE
To investigate the use of high resolution computed tomography (HRCT) in diagnosis of patients with fibrosing alveolitis associated with systemic sclerosis (FA-SSc), and to determine predictors of disease progression.


METHODS
We retrospectively studied 90 patients with SSc who had undergone an initial (Time 1) and followup (Time 2) clinical and HRCT evaluation, with a mean +/- SD interval of 5.14 +/- 2.98 years between T1 and T2.


RESULTS
At T1, HRCT was normal in 40 patients; at T2, 34/40 (85%) continued to have a normal HRCT. For the 50 patients with FA-SSc on HRCT scan at T1, the overall disease progression comprised extension of lung changes toward the apices with worsening of lung fibrosis at T2. Among the 37 patients who had areas of isolated ground-glass opacities at T1, 25 (68%) had progression of lung fibrosis at T2. These 25 patients were mostly men, who showed a more marked decrease of diffusing capacity and a longer interval between T1 and T2.


CONCLUSIONS
The results emphasize the good longterm prognosis indicated by a normal initial HRCT in SSc. Patients with FA-SSc with abnormal HRCT experienced progressive replacement of ground-glass opacities by honeycombing and/or traction bronchiectasis/bronchiolectasis. Ground-glass opacity is probably the first step of lung fibrosis in SSc, and treatment should be discussed even at this early stage.
Launay
David
D
Department of Internal Medicine, Claude-Huriez Hospital, National Center for Vascular Manifestations of Scleroderma, France.
Remy-Jardin
Martine
M
Michon-Pasturel
Ulrique
U
Mastora
Ioana
I
Hachulla
Eric
E
Lambert
Marc
M
Delannoy
Valerie
V
Queyrel
Viviane
V
Duhamel
Alain
A
Matran
Regis
R
De Groote
Pascal
P
Hatron
Pierre-Yves
PY
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*