Summary
The real utility of high resolution computed tomography (HRCT) for early detection of lung involvement was investigated in eighteen patients affected with systemic sclerosis (SSc). The results obtained from HRCT have been compared with traditional (chest radiographs, pulmonary function tests (PFT)) and nontraditional (ventilation and perfusion scintiscan) modalities of lung investigation. A significant statistical correlation (p<0.001) between HRCT scans and chest radiographs was observed. Moreover, HRCT was more sensitive in the detection of early pulmonary interstitial involvement and more accurate in the assessment of interstitial fibrosis in cases with severe lung involvement. A statistical correlation (P<0.001) between HRCT and the modalities of investigation of alveolo-capillary membrane — as PFT and ventilation scintiscan — was also observed. These results indicate that in SSc HRCT may be a useful technique for assessing early pulmonary involvement and for complementing other methodologies of investigation of lung function.
Similar content being viewed by others
References
Pugatch, R.D., Faling, L.J. Computed tomography of the thorax: a status report. Chest 1981, 80, 618–626.
Webb, W.R. Advances in computed tomography of the thorax. Radiol Clin North Am 1983, 21, 723–739.
Naidich, D.P., Mc Conley, D.I., Khouri, N.F., Stitik, F.P., Siegelman, S.S. Computed tomography of bronchiectasis. J Comput Assist Tomogr 1982, 6, 437–444.
Kuhlman, J.E., Fishman, E.K., Siegelman, S.S. Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis. Radiology 1985, 157, 611–614.
Khouri, N.F., Siegelman, S.S. Computed tomography of the pulmonary parenchyma II. Interstitial disease. J Thorac Imaging 1985, 1, 54–64.
Bergin, C.J., Muller, N.L. CT in the diagnosis of interstitial disease. AJR 1985, 145, 505–510.
Kreel, L. Computed Tomography of interstitial pulmonary disease. CT 1982, 6, 181–199.
Nakata, H., Kimoto, T., Nakayama, T., Kido, M., Miyazaki, N., Harada, S. Diffuse peripheral lung disease: evaluation by high resolution computed tomography. Radiology 1985, 157, 181–185.
Aberle, D.R., Gamsu, G., Ray, C.S., Feuerstein, I.M. Asbestosrelated pleural and parenchymal fibrosis: Detection with high-resolution CT. Radiology 1988, 166, 729–734.
Muller, N.L., Miller, R.R. Computed tomography of chronic diffuse infiltrative lung disease. Am Rev Respir Dis 1990, 142, parts I & II.
Masi, A.T., Rodnan, G.P., Medseger, T.A. et al. Preliminary criteria for the classification of systemic sclerosis (scleroderma). Arthritis Rheum 1980, 25, 581–90.
LeRoy, E.C., Black, C., Fleischmaier, R. et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 1988, 15, 202–205.
Matucci-Cerinic, M., Pignone, A., Iannone, F. et al. Clinical correlation of plasma angiotensin converting enzyme (ACE) activity in systemic sclerosis: a longitudinal study of plasma ACE levels, endothelial injury and lung involvement. Resp Med 1990, 84, 283–287.
Ogilvie, C.M., Forster, R.E., Blakemore, W.S., Morton, J.W. A standardized breathholding technique for the clinical measurement of the diffusing capacity of the lung for carbon monoxide. J Clin Invest 1957, 36, 1.
Cotes, J.R. Lung Function. Oxford: Blackwell Scientific publication, 1975, pp. 381.
Silver, R.M., Metcalf, J.F., Stanley, J.H., LeRoy, E.C. Interstitial lung disease in scleroderma. Arthritis Rheum 1984, 27, 1254–1262.
Bader, R.A., Bader, M.E. Thoracic manifestations of collagen diseases, In: Textbook of Pulmonary Diseases, Ed: Baum, G.L. Bolton, Little brown, Boston, 342–344.
DeMuth, G.R., Furstemberg, N.A., Dabich, L. et al. Pulmonary manifestations of progressive systemic sclerosis. Am J Med 1978, 94–103.
Furst, D.E., Davis, J.A., Clements, P.J., Chopra, S.K., Theofilopoulos, A.N., Chia, D. Abnormalities of pulmonary vascular dynamics and inflammation in early progressive systemic sclerosis. Arthritis Rheum 1982, 24, 1403–1408.
D'Angelo, W.A., Fries, J.F., Masi, A.T., Shulman, L.E. Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med 1969, 46, 428–439.
Bagg, L.R., Hughes, D.T.D. Serial pulmonary function tests in progressive systemic sclerosis. Thorax 1979, 34, 224–228.
Colp, C.R., Riker, J., William, M.H. Serial changes in scleroderma and idiopathic interstitial lung disease. Arch Intern Med 1973, 132, 506–515.
Bjerke, R.D., Tashkin, D.P., Clements, P.J., Chopra, S.K., Gong, H. jr., Bein, M. Small airways in progressive systemic sclerosis (PSS). Am J Med 1979, 66, 201–209.
Greenwald, G.I., Tashkin, D.P., Gong, H. et al. Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study. Am J Med 1987, 83, 83–92.
Guttaduria, M., Ellman, H., Emmanual, G., Kaplan, D., Diamond, H. Pulmonary function in scleroderma. Arthritis Rheum 1977, 20, 1071–1079.
Edelson, J.D., Hyland, R.H., Ramsden, M. et al. Lung inflammation in scleroderma; clinical, radiographic, physiologic and cytopathological features. J Rheumatol 1985, 12, 957–963.
Crystal, R.G., Fulmer, J.D., Roberts, W.L. et al. Idiopathic pulmonary fibrosis: clinical, histologic, radiographic, physiologic, scintigraphic, cytologic and biochemical aspects. Ann Intern Med 1976, 85, 769–788.
Epler, G.R., McCloud, T.C., Gamsler, E.A. et al. Normal chest roentgenograms in chronic diffuse infiltrative disease. N Engl J Med 1978, 298, 934–936.
Koba, H., Kato, S., Watanabe, H. et al. CT of the lung fibrosis in progressive systemic sclerosis. Rinsho-Hoshasen 1989, 34, 107–113.
Harrison, N.K., Glanville, A.R., Strickland, B. et al. Pulmonary involvement in systemic sclerosis: the detection of early changes by thin section CT scan, bronchoalveolar lavage and99 mc DTPA clearance. Resp Med 1989, 83, 403–414.
Schurawitzki, H., Stiglbauer, R., Graninger, W. et al. Interstitial lung disease in progressive systemic sclerosis: HRCT versus radiography. Radiology 1990, 176, 755–759.
Warrick, J.H., Meenakshi, B., Schabel, S.I., Silver, R.M., High resolution computed tomography in early scleroderma lung disease. J. Rheumatol 1991, 18, 10, 1520–1525.
Jones, J.G., Minty, B.D., Lowler, P., Hudlands, G., Crowley, J.C.W., Veall, N. Increased alveolar epithelial permeability in cigarette smokers. Lancet 1980, i, 66–8.
Rinderknecht, J., Shapiro, L., Kronthammer, M. et al. Accelerated clearance of small solutes from the lungs in interstitial lung disease. Am Rev Resp Dis 1980, 121, 105–117.
Minty, B.D., Jordan, C., Jones, J.G. Rapid improvement in abnormal pulmonary epithelial permeability after stopping cigarettes. Br Med J 1981, 282, 1183–1186.
Jacobs, M.P., Baughman, R.P., Hughes, J., Fernandes-Ulloa, M. Radioaereosol lung clearance in patients with active sarcoidosis. Am Rev Resp Dis 1985, 131, 63–67.
Chopra, S.K., Taplin, G.V., Tashkin, D.P., Elam, D. Lung clearance of soluble radioaereosol of different molecular weights in systemic sclerosis. Thorax 1979, 34, 63–67.
Rammana, L., Tashkin, D.P., Taplin, G.V. et. al. Radioaereosol lung imaging in chronic obstructive pulmonary disease. Comparison with pulmonary function tests and roentgenography. Chest 1975, 68, 634–640.
Dolovich, M.B., Sanchis, J., Rosmann, C. et. al. Aereosol penetrance: a sensitive index of peripheral airways obstruction. J Appl Physiol 1976, 40, 468–471.
Short, M.D., Dowsett, D.J., Heaf, P.J.D., Davia, D., Thornson, M.L. A comparison between monodisperse Tc 99m labeled aereosol particles and Kr 81m for the assessment of lung function. J Nucl Med 1979, 20, 194–200.
Silver, R.M., LeRoy, E.C. Systemic sclerosis (Scleroderma). In: Immunological Diseases. Eds: Samter, H., Talmage, D.W., Frank, H.M., Austen, K.F., Claman, H.N. Little Brown, Boston, 1988.
Kahleh, M.B., LeRoy, E.C. Endothelial injury in scleroderma: a protease mechanism. J Lab Clin Med 1983, 101, 553.
Norton, W.L., Nardo, G.M. Vascular disease in progressive systemic sclerosis. Ann Intern Med 1970, 73, 312–324.
Young, R.H., Mark, G.J. Pulmonary vascular changes in scleroderma. Am J Med 1978, 64, 998–1004.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pignone, A., Matucci-Cerinic, M., Lombardi, A. et al. High resolution computed tomography in systemic sclerosis. Real diagnostic utilities in the assessment of pulmonary involvement and comparison with other modalities of lung investigation. Clin Rheumatol 11, 465–472 (1992). https://doi.org/10.1007/BF02283100
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF02283100