Pulmonary Artery Involvement and Parenchymal Lung Changes in Behçet Disease: A Comparative Cohort Thoracic Computed Tomography Imaging Study.

Background/objective: Pulmonary involvement of Behçet disease (BD) typically manifests as vascular involvement in the form of pulmonary artery thrombosis and/or aneurysm, although various parenchymal lung findings may also be observed. We aimed to analyze the indications for imaging and thoracic computed tomography (TCT) findings in BD patients.

Methods: In this medical records review, single-center, comparative cohort study, 196 BD patients who underwent TCT for any reason between July 2020 and July 2024 were included. The patients' demographic data, disease-related clinical features, indications for TCT, and TCT findings were recorded.

Results: The mean age of the patients was 40.0 ± 12.0 years, with a female-to-male ratio of 56/140 and disease duration of 8.9 ± 9.1 years. The most common indications for TCT imaging were suspected pulmonary vascular involvement (PVI) (139/196), unexplained acute phase elevation (46/196), and infection (36/196). PVI was present in 23 patients. Patients with PVI also exhibited additional parenchymal findings. Ground-glass opacities and atelectasis were significantly more common in patients with PVI compared with those without.

Conclusion: TCT imaging is essential for identifying both vascular and parenchymal pulmonary complications in BD, especially in patients with atypical symptoms or elevated inflammatory markers.