Centrilobular nodules in high resolution computed tomography of the lung in IPAH patients - preliminary data concerning clinico-radiological correlates.
BACKGROUND
Inhomogeneity of lung attenuation pattern is observed in high resolution chest computed tomography (HRCT) in some IPAH patients despite lack of interstitial lung disease. Such radiological changes are described either as ill-defined centrilobular nodules (CN) or as focal ground glass opacities (FGGO). There is no consensus in the literature, whether they indicate the distinct type of IPAH, or pulmonary venoocclusive disease (PVOD) with subtle radiological changes. Thus the aim of the present pilot study was to assess the frequency and clinical significance of inhomogenic lung attenuation pattern in IPAH.


METHODS
52 IPAH patients (38 females, 14 males, mean age 41 years ± 15 years), entered the study. All available chest CT scans were reviewed retrospectively by the experienced radiologist, not aware about the clinical data of the patients.


RESULTS
CN were found in 10 patients (19%), FGGO - in 12 patients (23%). No lymphadenopathy or interlobular septal thickening suggestive of PVOD were found. The significant differences between CN and the remaining patients included: lower mean age - 31 and 43.5 years, (p = 0.02), lack of persistent foramen ovale (PFO) - 0% and 43% (p = 0.03), and higher mean right atrial pressure (mRAP) - 12.5 mm Hg and 7.94 mm Hg (p = 0.01). No significant survival differences were observed between the groups of CN, FGGO and the remaining patients.


CONCLUSIONS
Centrilobular nodules in IPAH were combined with lack of PFO, higher mRAP and younger age of patients.
Ist Department of Lung Diseases National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland. monika.szturmowicz@gmail.com.
Monika
M
Szturmowicz
Aneta
A
Kacprzak
Barbara
B
Burakowska
Agnieszka
A
Skoczylas
Iwona
I
Bestry
Jan
J
Kuś
Anna
A
Fijałkowska
Adam
A
Torbicki
Marcin
M
Kurzyna
D000328:Adult; D000367:Age Factors; D062185:Atrial Pressure; D065627:Familial Primary Pulmonary Hypertension / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D054085:Foramen Ovale / Q000473:pathology; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011668:Pulmonary Veno-Occlusive Disease / Q000175:diagnosis / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
centrilobular nodules; high resolution computed tomography of the lung; idiopathic pulmonary arterial hypertension