RADIOLOGICAL AND MORPHOLOGICAL PATTERNS OF IDIOPATHIC PULMONARY FIBROSIS FROM THE EARLIEST MANIFESTATIONS TO THE OUTCOME
https://doi.org/10.22328/2079-5343-2020-11-2-89-98
Abstract
Purpose. To evaluate radiological and morphological patterns of IPF in their long-term monitoring.
Materials and methods. 676 patients with clinical and radiological patterns of IPF (53,3±15,2g, f/m — 412/264). HRCT, SPECT, PFTs, echocardiography.
Results. UIP was characterized by increase in size and spread of «honeycomb lung», the appearance of new areas of subpleural «GGO» and their transformation first into honeycombing, in 142 patients (21,0%) on a CT-scan. SPECT revealed apparent decrease in pulmonary microcirculation. Patients did not need morphological verification, their DLCO was less than 30% D. NSIP was found in 439 patients (64,9%), CT showed subpleural reticulation changes and «GGO» without «honeycombing», but during the monitoring they transformed into honeycombing. Morphologically it was «honeycombing», SPECT showed growing abnormalities, DLCO was 50% D. The exacerbation of IPF was found in 24 patients (3,5%) on a CT-scan and SPECT and histologically it was manifested by acute interstitial pneumonia and cryptogenic organizing pneumonia. It led to the progression of fibrosis in 11 patients. Early manifestations of IPF: CT showed subpleural areas with «GGO» and reticulation changes in 32 patients (4,7%), later they transformed into IPF in 21 patients. SPECT showed minimal abnormalities in microcirculation. Primary fibrosing morphological changes, DLCO is 70% D.
Conclusions: The accumulation of experience of clinical and radiological examination of patients with IPF justifies a need to develop new approaches to diagnosing and treatment.
About the Authors
A. A. Speranskaia
Pavlov First St. Petersburg State Medical University
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
L. N. Novikova
Pavlov First St. Petersburg State Medical University
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
I. V. Dvorakovskaia
Pavlov First St. Petersburg State Medical University
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
V. P. Zolotnitskaia
Pavlov First St. Petersburg State Medical University
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
M. A. Vasilieva
Pavlov First St. Petersburg State Medical University
Russian Federation
St. Petersburg
Russian Federation
St. Petersburg
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Review
For citations:
Speranskaia A.A., Novikova L.N., Dvorakovskaia I.V., Zolotnitskaia V.P., Vasilieva M.A. RADIOLOGICAL AND MORPHOLOGICAL PATTERNS OF IDIOPATHIC PULMONARY FIBROSIS FROM THE EARLIEST MANIFESTATIONS TO THE OUTCOME. Diagnostic radiology and radiotherapy. 2020;11(2):89-98. (In Russ.) https://doi.org/10.22328/2079-5343-2020-11-2-89-98
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