RADIOLOGICAL EVALUATION OF INTERSTITIAL LUNG DISEASES ON HIGH-RESOLUTION COMPUTED TOMOGRAPHY IN TERTIARY CARE CENTER OF NORTH INDIA
DOI:
https://doi.org/10.22159/ajpcr.2024.v17i2.47769Keywords:
High-resolution computed tomography, Interstitial lung diseases, Usual interstitial pneumonia,, Non-specific interstitial pneumonia, Idiopathic pulmonary fibrosisAbstract
Objective: This study assessed the various high-resolution computed tomography (HRCT) patterns of interstitial lung diseases (ILDs) and to differentially diagnose ILD based on their clinical findings and distribution patterns.
Methods: The study was conducted in the Department of Radiodiagnosis, Government Medical College and Rajindra Hospital, Patiala, Punjab, India. Forty-three patients with clinical suspicion of ILD were enrolled in the study. HRCT scans of the chest were done in all the cases taken in the study.
Results: The mean age (±he age group of 51–60 years. We found slight female preponderance with females accounting for 53.5% and males accounting for 46.5% of the caseload. The most common presenting complaint was dyspnea on exertion (83.7%) followed by cough in 69.8%. The most frequent HRCT finding was septal thickening (90.7%), followed by tractional bronchiectasis (83.7%), fibrotic changes (72.1%), ground-glass opacities (65.1%), and honeycombing (58.1%). Based on HRCT findings, the most common HRCT pattern was the typical usual interstitial pneumonia pattern (58.1%), followed by the non-specific interstitial pneumonia pattern. The final diagnoses were made based on clinic-radiological findings and by the exclusion of other possibilities. The most common ILD reported was idiopathic pulmonary fibrosis (39.5%), followed by connective tissue disorder-ILD (20.9%), and SR-ILD (13.9%). This is followed by idiopathic non-specific interstitial pneumonia (11.6%), hypersensitivity pneumonitis (6.9%), and cryptogenic organizing pneumonia (2.3%).
Conclusion: HRCT is a valuable technique for evaluating various ILDs even when chest X-rays are normal. It can differentially diagnose ILDs based on their clinical findings and distribution patterns.
Downloads
References
Neurohr C, Behr J. Diagnostik und therapie interstitieller lungenerkrankungen [Diagnosis and therapy of interstitial lung diseases]. Dtsch Med Wochenschr 2009;134:524-9. (German). doi: 10.1055/s-0029-1208082, PMID: 19259911
Ward J, McDonald C. Interstitial lung disease - an approach to diagnosis and management. Aust Fam Physician 2010;39:106-10. PMID: 20369109
Travis WD, Costabel U, Hansell DM, King TE Jr., Lynch DA, Nicholson AG, et al. An official American Thoracic Society/ European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013;188:733-48. doi: 10.1164/ rccm.201308-1483ST, PMID: 24032382; PMCID: PMC5803655
Torres PP, Rabahi MF, Moreira MA, Escuissato DL, Meirelles GS, Marchiori E. Importance of chest HRCT in the diagnostic evaluation of fibrosing interstitial lung diseases. J Bras Pneumol 2021;47:e20200096. doi: 10.36416/1806-3756/e20200096, PMID: 34076172; PMCID: PMC8332714
Strange C, Highland KB. Interstitial lung disease in the patient who has connective tissue disease. Clin Chest Med 2004;25:549-59, vii. doi: 10.1016/j.ccm.2004.05.009, PMID: 15331191
Shah AK, Kushwah AP, Pandey S, Tomar SP. Role of HRCT in interstitial lung disease with radiographic correlation. J Evid Based Med Healthc 2020;7:2573-8.
Bhat IM, Bhat JA, Shamshad M, Malik AA, Mir S. Role of high-resolution computed tomography chest in interstitial lung diseases. Int J Sci Study 2016;4:20-6.
Doshi JA, Mundhra KS, Shah DS, Shah SN, Patel TV, Bhatt A. Role of high-resolution CT thorax in diagnosing interstitial lung disease and its association with smoking and connective tissue disorder. Cureus 2022;14:e31107. doi: 10.7759/cureus.31107, PMID: 36475156; PMCID: PMC9719881
Badarkhe-Patil P, Kawade D, Titare P, Rote-Kaginalkar V. HRCT assessment of interstitial lung diseases. Int J Contemp Med Res 2016;3:2426-30.
Muhammed SK, Anithkumari K, Fathahudeen A, Jayprakash B, Ronaid WB, Sreekala, et al. Aetiology and clinic-radiological profile of interstitial lung disease in a tertiary care centre. J Pulmon 2011;13:12-5.
Kim TS, Lee KS, Chung MP, Han J, Park JS, Hwang JH, et al. Nonspecific interstitial pneumonia with fibrosis: High-resolution CT and pathologic findings. AJR Am J Roentgenol 1998;171:1645-50. doi: 10.2214/ajr.171.6.9843306, PMID: 9843306
Singh S, Collins BF, Sharma BB, Joshi JM, Talwar D, Katiyar S, et al. Interstitial lung disease in India. Results of a prospective registry. Am J Respir Crit Care Med 2017;195:801-13. doi: 10.1164/rccm.201607- 1484OC, PMID: 27684041
Sen T, Udwadia ZF. Retrospective study of interstitial lung disease in a tertiary care centre in India. Indian J Chest Dis Allied Sci 2010;52:207-11. PMID: 21302597
Published
How to Cite
Issue
Section
Copyright (c) 2023 Mohit Threja, Jaswinder K, Amanjeet Kaur, Surinderpal Singh
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.