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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

Μαγκανάς, Ελευθέριος Μηνά Γεωργίου

Thesis advisor

Γκουρτσογιάννης, Νικόλαος

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.

Physical description

113 σ. : πιν. ; 30 εκ.

Language

Greek

Subject

Lung Diseases radiography

Tomography, X-ray Computed

Πνευμονικά νοσήματα Ακτινογραφία

Τομογραφία υπολογιστική με ακτίνες X

Issue date

2007-12-14

Collection