薄层 CT 在肺纤维化(包括最近定义的进行性肺纤维化)分类和管理中的应用。

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Rosita M Shah, Ana M Kolansky, Seth Kligerman
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引用次数: 0

摘要

虽然特发性肺纤维化(IPF)是最常见的肺纤维化疾病,但还有许多其他原因导致的肺纤维化,其特征通常是肺损伤和炎症。虽然肺纤维化通常是逐渐进展的,对免疫调节也有反应,但有些病例可能进展迅速,存活率降低(与 IPF 相似),影像学特征与 IPF 重叠,包括以周围和基底侧网状结构、蜂窝状、牵引性支气管扩张或支气管扩张为特征的寻常间质性肺炎(UIP)模式疾病。最近,进行性肺纤维化一词被用来描述非 IPF 肺部疾病,这种疾病在一年内会出现临床、生理和/或放射学进展,并可能接受抗纤维化治疗。因此,对肺纤维化患者进行适当的分类对治疗和预后都有影响,可通过考虑以下分类:(a) 放射性 UIP 模式和 IPF 诊断,(b) 放射性 UIP 模式和非 IPF 诊断,以及 (c) 放射性非 UIP 模式和非 IPF 诊断。通过注意到纤维化的加重,放射科医生可以帮助选择使用抗纤维化药物治疗的患者,从而提高患者的生存率。由于放射科医生可能最先发现正在发展的肺纤维化和整体进展,本文回顾了肺纤维化的影像学特征及其在非 IPF 型肺纤维化、进展性肺纤维化中的意义以及对治疗的影响。关键词:特发性肺纤维化特发性肺纤维化 进行性肺纤维化 薄层 CT 通常间质性肺炎 © RSNA, 2024.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Thin-Section CT in the Categorization and Management of Pulmonary Fibrosis including Recently Defined Progressive Pulmonary Fibrosis.

While idiopathic pulmonary fibrosis (IPF) is the most common type of fibrotic lung disease, there are numerous other causes of pulmonary fibrosis that are often characterized by lung injury and inflammation. Although often gradually progressive and responsive to immune modulation, some cases may progress rapidly with reduced survival rates (similar to IPF) and with imaging features that overlap with IPF, including usual interstitial pneumonia (UIP)-pattern disease characterized by peripheral and basilar predominant reticulation, honeycombing, and traction bronchiectasis or bronchiolectasis. Recently, the term progressive pulmonary fibrosis has been used to describe non-IPF lung disease that over the course of a year demonstrates clinical, physiologic, and/or radiologic progression and may be treated with antifibrotic therapy. As such, appropriate categorization of the patient with fibrosis has implications for therapy and prognosis and may be facilitated by considering the following categories: (a) radiologic UIP pattern and IPF diagnosis, (b) radiologic UIP pattern and non-IPF diagnosis, and (c) radiologic non-UIP pattern and non-IPF diagnosis. By noting increasing fibrosis, the radiologist contributes to the selection of patients in which therapy with antifibrotics can improve survival. As the radiologist may be first to identify developing fibrosis and overall progression, this article reviews imaging features of pulmonary fibrosis and their significance in non-IPF-pattern fibrosis, progressive pulmonary fibrosis, and implications for therapy. Keywords: Idiopathic Pulmonary Fibrosis, Progressive Pulmonary Fibrosis, Thin-Section CT, Usual Interstitial Pneumonia © RSNA, 2024.

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CiteScore
20.40
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