PMID: 9524598Apr 3, 1998Paper

Course of idiopathic pulmonary fibrosis of the Wells grade III at presentation. Study using high-resolution computerized tomography

La Radiologia medica
Maurizio ZompatoriP Bertaccini

Abstract

We studied the HRCT and functional evolution of idiopathic pulmonary fibrosis (IPF) patients presenting with Wells grade III--prevalent fibrosis. We sequentially studied the HRCT and functional findings of 16 IPF patients, at presentation and at 1 year. All patients had a typical grade III IPF pattern; those with the most severe clinical presentation were treated (9/16). The main HRCT parameters were the extent of interstitial involvement and emphysema (visual score) and the mean diameter of lung cysts in honeycombing regions. Most of our grade III IPF patients exhibited a slowly progressive deterioration, with no accelerated parenchymal opacification. Deterioration was found on HRCT images in 56.2% of patients (p = .02), with a mean monthly increase of .56%. Fibrosis extent, evaluated as HRCT visual score at presentation, was significantly correlated with viability and PaO2, values (p = .01). Follow-up HRCT scores were also significantly correlated with viability (p = .004). The mean diameter of honeycomb lung cysts increased in 25% of patients. Emphysema was associated at presentation in 50% of patients--all of them former smokers; it was less diffuse than interstitial involvement (15% of total lung volume versus 46.7% at pre...Continue Reading

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