RESUMO
PURPOSE: It has been reported that the prognosis differs between patients who have collagen vascular diseaseassociated interstitial pneumonia (CVD-IP) and those with idiopathic IP (IIP). In this study, chest computed tomography (CT) findings were compared between patients with CVD-IP and IIP. MATERIALS AND METHODS: A retrospective analysis was performed of 47 consecutive patients (23 with CVD-IP and 24 with IIP). The lower-lobe volume (LLV), total lung volume (TLV), and their ratio (LLV/TLV) were determined by volumetry using three-dimensional computed tomography (CT). RESULTS: There was no significant difference of the LLV/TLV ratio between the CVD-IP and IIP groups. However, the LLV/TLV ratio was <0.33 in 9/23 patients with CVD-IP versus 2/24 patients with IIP, and there was a significant difference in the percentage of patients with a ratio<0.33 between the CVD-IP and IIP groups (p = 0.01). The LLV/TLV ratio was not influenced by the severity of lung disease. CONCLUSIONS: Measuring the LLV/TLV ratio by threedimensional CT can help distinguish between CVD-IP and IIP at initial diagnosis, especially in patients with CVD-IP who have pulmonary involvement before other organ diseases and symptoms caused by CVD.
Assuntos
Doenças do Colágeno/diagnóstico por imagem , Imageamento Tridimensional , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Doenças Vasculares/diagnóstico por imagem , Idoso , Estudos de Casos e Controles , Doenças do Colágeno/patologia , Feminino , Humanos , Doenças Pulmonares Intersticiais/patologia , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Prognóstico , Testes de Função Respiratória , Estudos Retrospectivos , Doenças Vasculares/patologiaRESUMO
The chronic inflammation of bronchial asthma is characterized by swelling of the subepithelial mucosa. However, it is difficult to assess subepithelial edema clinically. We report the case of a patient with asthma whose subepithelial edema was evaluated by endobronchial ultrasonography. Receiving montelukast 10 mg/day for 2 weeks, a 42-year-old man with mild, persistent asthma had his symptoms controlled by beta2-inhalation alone. Pretreatment endobronchial ultrasonography revealed subepithelial thickening in the right main stem bronchus, with a low absorption area suggestive of edema. Two weeks of montelukast therapy diminished the amount of subepithelial edema. Endobronchial ultrasonography is a promising technique for determining subepithelial edema in the asthmatic airway.
