|ECR 2019 / C-2418|
|HRCT features in patients with undifferentiated connective tissue disease|
The most common CT features were those related to fibrosis: traction bronchiectasis [20 (91%) patients], reticulations [19 (86%) patients] and honeycombing [16 (73%) patients]. Airways abnormalities (68%) were also frequently seen; nodules were observed in 5 (23%) patients. All the thoracic findings found on HRCT scans of our patients are summarized in Fig.1 and Fig.2.
Interobserver agreement for the presence of HRCT features was mostly good (good to excellent agreement), except for the evaluation of GGO (moderate agreement). (Fig.3)
Reticulations, honeycombing and GGO were bilateral in most of cases and showed predominance in the lower zone of the lung; in one patient with NSIP CT pattern honeycombing was predominantly apical.
The extent of honeycombing on the baseline CT scan was grade 1 in 9 (53%) patients and grade 2 in 7 (41%) patients; during follow-up we observed an increase of one or two grades in 13 (76,5%) patients. The extent of reticulation of grade higher than 2 was the most frequent; there was a significant increase (> 25%) in 3 (14%) patients. GGO showed a grade 2 extent in the majority of cases and increased significantly in 2 patients. In most patients, traction bronchiectasis/ bronchiolectasis showed an extent of grade 2.
Among 22 HRCT scans were identified 3 major CT pattern: 13 (59%) were classified as compatible with UIP, 7 (32%) with NSIP and 1 (5%) with OP; one patient was considered having the indeterminate pattern. (Fig.4)
Enlargement of the pulmonary artery was observed in 13 (59%) patients and 6 of the 7 patients with NSIP CT pattern were in this group.
Considering the accessory findings, esophageal dilatation was assessed in 8 (36%) patients and hiatal hernia in 6 (27%) patients. Moreover, half of the patients in our study group had lymph nodes enlargement.
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