title: Initial limited three-level thin-section computed tomography scorings predict the prognosis of acute/subacute interstitial pneumonia in patients with dermatomyositis.
abstract: OBJECTIVE
  We investigated the prediction of outcomes of patients with dermatomyositis with acute/subacute interstitial pneumonia (DM-A/SIP) on the basis of chest computed tomography (CT) images.
  
  
  METHODS
  In 20 patients with DM-A/SIP (13 survivors; seven deaths), the relationships between prognostic outcomes and chest high-resolution CT (HRCT) findings or limited three-level thin-section CT scoring on the first examination were retrospectively investigated.
  
  
  RESULTS
  No significant difference was noted in chest HRCT findings between the survivor group and death group. The ground-glass opacity (GGO) scores of the right upper and middle lobes and left upper lobe, and the fibrosis score of the right middle lobe were significantly higher in the death group than in the survivor group (p = 0.01, 0.001, 0.02, and 0.02, respectively). The influence of the GGO score of the right middle lobe on death from IP was the strongest among the items examined, and it was independently significant (p = 0.01). A right middle lobe GGO score of ≥3 (GGO ≥ 25% of the lobe) was determined to be the best cut-off value for a poor prognosis (sensitivity: 85.7%, specificity: 85.7%), and the survival rate after 24 weeks was significantly lower in patients with a right middle lobe GGO score of ≥3 (survival rate: 0.0%) than in those with a score of< 3 (92.9%) (p < 0.0001).
  
  
  CONCLUSIONS
  The prognosis of patients with DM-A/SIP was poor when the range of right middle lobe GGO was 25% or higher on limited three-level thin-section CT.
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Takuya
authors.initials: T
authors.lastname: Kotani
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: b Department of Respiratory Medicine , Yodogawa Christian Hospital , Osaka , Japan , and.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yoshimatsu
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ishida
authors.affiliation: c Department of Internal Medicine , Aino Hospital , Osaka , Japan.
authors.forename: Naomune
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Youhei
authors.initials: Y
authors.lastname: Fujiki
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Oda
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Kentaro
authors.initials: K
authors.lastname: Isoda
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hata
authors.affiliation: b Department of Respiratory Medicine , Yodogawa Christian Hospital , Osaka , Japan , and.
authors.forename: Takao
authors.initials: T
authors.lastname: Kamimori
authors.affiliation: b Department of Respiratory Medicine , Yodogawa Christian Hospital , Osaka , Japan , and.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.affiliation: a First Department of Internal Medicine , Osaka Medical College , Takatsuki, Osaka , Japan .
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003882:Dermatomyositis / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: CT scoring; Chest CT; Dermatomyositis; Interstitial pneumonia; Prognosis