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The most common HRCT findings in patients with RA-ILD are usual interstitial pneumonia (UIP) (Figure 1), nonspecific interstitial pneumonia (NSIP) (Figure 2), lymphocytic interstitial pneumonia, organizing pneumonia, diffuse alveolar damage, respiratory bronchiolitis, and desquamative interstitial pneumonia (11).
The aim of this study is to know the prevalence and patters of pulmonary involvement in early RA patients by HRCT thorax and to correlate them with clinical and laboratory parameters.
In the event of suspected occult disease, comprehensive ocular examination, HRCT, and a whole-body PET scan for the detection of lymphadenopathies are considered appropriate.
Subjective imaging analysis was done by one experienced thoracic radiologist, blinded to the patients' clinical data, who identified the following characteristics on HRCT: presence or absence and degree (mild, moderate, severe) of emphysema, types of emphysema (centrilobular, panlobular, paraseptal), presence or absence of airway disease (wall thickening, irregularity, airway opacities), presence or absence of air trapping on expiratory images, and presence or absence of bronchiectasis.
The 2011 official American Thoracic Society and European Respiratory Society (ATS/ERS) statement on the diagnosis and treatment of idiopathic pulmonary fibrosis (IPF), among other recommendations, recognized that a histopathologic confirmation was not needed in patients with idiopathic ILD who had a usual interstitial pneumonia (UIP) pattern on HRCT of the chest.
[15,16] Radiological examinations were performed with the HRCT. The existence of bronchiectasis was confirmed and scored by two.blinded radiologists, using the Reid classification and Reiff scoring, in addition, emphysema was also defined.
HRCT and MR imaging including DW sequences allow detailed evaluation of this region.
Chest HRCT [Figure 1]c revealed that ground-glass opacities were absorbed and irregular thin-wall cyst in the right middle lobe.
Meta-analyses have shown wide variability in the metrics of HRCT diagnosis of otosclerosis with more recent reports supporting collective sensitivities of over 90% for early fenestral involvement.
Among the 42 cases in the current study with the lowest diagnostic confidence following HRCT i.e., those without definite or probable UIP the Envisia classifier provided even more robust results (88% specificity and 76% sensitivity).
- In cases of immediate FP in the absence of a visible fracture line on HRCT, a medical treatment with steroids is given.
(B) A high-resolution computed tomograph (HRCT) of the lungs, demonstrating dominant basal subpleural reticulation, traction bronchiectasis and early honeycomb changes.
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- Hrdlicka, Aleš
- Hrdlicka, Ales
- Hrdlis?ka, Ales?