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Identifier |
000349701 |
Title |
Διερεύνηση της συμμετοχής των μεγάλων αεραγωγών και βρογχιολίων στις διάχυτες διάμεσες πνευμονοπάθειες με έμφαση στη σαρκοείδωση και στην κοκκιωμάτωση wegener : μελέτη με υπολογιστική τομογραφία υψηλής ευκρίνειας σε εισπνευστική και εκπνευστική φάση |
Author
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Μαγκανάς, Ελευθέριος Μηνά Γεωργίου
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Thesis advisor
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Γκουρτσογιάννης, Νικόλαος
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Abstract |
Purpose: To assess the presence of bronchus and bronchioles involvement, in the diffuse
lung diseases especially in sarcoidosis and Wegener’s granulomatosis on chest Highresolution
CT (HRCT) in inspiration and in expiration.
Material and Methods: Thirty consecutive patients with sarcoidosis and twenty one with
Wegener’s granulomatosis underwent inspiratory and expiratory HRCT. HRCT images in
inspiration were evaluated for: extent and distribution of parenchymal involvement, predominant
pattern, bronchus-bronchioles impairment. HRCT images in expiration were assessed
for: presence, distribution and air-trapping extent (AT). Attenuation difference in the AT regions
at expiration and the respective ones at inspiration were calculated. The presence and
extent of AT were correlated with: extent of involvement, predominant inspiratory patterns,
bronchus-bronchioles involvement. The statistical analysis was evaluated by Kruskal-Wallis
test by using the SPSS 15 statistical program.
Results: Sarcoidosis: The predominant patterns in inspiratory HRCT scans were: nodular in
12 patients, fibrotic in 4 patients, ground-glass opacity in 3 linear in 3. Mixed pattern was
present in 5 patients. The extent of parenchymal involvement was 0% - 80%. Bronchusbronchioles
impairment was found in 16/30 patients.
The extent of AT ranged from 0%-31.5%. AT was present in 25/30(83.3%) patients with no
lung field predilection. Bilateral AT was present in 20/25 patients. AT was revealed in the
lower lung fields in all patients. In the posterior costophrenic angles AT was evaluated in
21/25 patients. Air-trapping was the only CT indication of pulmonary sarcoidosis in 3/30
(10%) patients who also had normal PFT. Attenuation difference between inspiration and expiration
ranged from − 40HU to 106HU (mean − 63.1HU ± 51.5HU). In 2 patients a paradoxical
decrease of lung attenuation was observed at expiration. No significant correlation
was found between AT extent at expiration, with predominant pattern, extent of lesions and
bronchus-bronchioles involvement at inspiration.
Wegener’s granulomatosis: The predominant patterns in inspiratory HRCT scans were: nodular
(nodules and or cavitating nodules) in 7 patients, ground-glass opacity in 5, fibrotic in 3
and in 1 patient opacity with air bronchogram. The extent of parenchymal involvement was
0% - 36.7%. Bronchus-bronchioles impairment was found in 14/21 patients.
AT was present in 7/21 patients with no lung field predilection and the extent was ranged
from 0% - 70.8%. Bilateral AT was present in all patients as well as in the posterior costophrenic
angles. Air-trapping was the only CT indication of pulmonary involvement from the
disease in 2/21 patients. Attenuation difference between inspiration and expiration ranged
from 32 HU to 106 HU (mean 60 ± 23.5 HU). No significant correlation was found between
AT extent at expiration, with predominant pattern, extent of lesions and bronchusbronchioles
involvement at inspiration.
Conclusions: Air-trapping is an additional HRCT finding in sarcoidosis and Wegener’s
granulomatosis. AT may involve any lung field, including costophrenic angles and may be
the only CT feature of pulmonary sarcoidosis and Wegener’s granulomatosis. No significant
correlation is found with extent of lesions in inspiration, predominant pattern and bronchus or
bronchioles involvement.
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Physical description |
113 σ. : πιν. ; 30 εκ. |
Language |
Greek |
Subject |
Lung Diseases radiography |
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Tomography, X-ray Computed |
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Πνευμονικά νοσήματα Ακτινογραφία |
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Τομογραφία υπολογιστική με ακτίνες X |
Issue date |
2007-12-14 |
Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/1/f/2/metadata-dlib-33bbce42f7021f86566ebe97e1a180e9_1252995570.tkl
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Views |
308 |