The role of chest CT in deciphering interstitial lung involvement: systemic sclerosis versus COVID-19
-
- Martina Orlandi
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Nicholas Landini
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—AOUC, Florence
-
- Gianluca Sambataro
- Regional Referral Centre for Rare Lung Diseases, A. O. U. ‘Policlinico G. Rodolico—San Marco’ Department of Clinical and Experimental Medicine, University of Catania
-
- Cosimo Nardi
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—AOUC, Florence
-
- Lorenzo Tofani
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Cosimo Bruni
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Silvia Bellando-Randone
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Jelena Blagojevic
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Daniela Melchiorre
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Michael Hughes
- Department of Rheumatology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
-
- Christopher P Denton
- University College London Division of Medicine, Centre for Rheumatology and Connective Tissue Diseases, London, UK
-
- Fabrizio Luppi
- Respiratory Unit, University of Milano-Bicocca, S. Gerardo Hospital, Monza
-
- Barbara Ruaro
- Department of Pulmonology, University Hospital of Cattinara, Trieste
-
- Francesca della Casa
- Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli
-
- Francesca W Rossi
- Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli
-
- Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano
-
- Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano
-
- Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC
-
- Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC
-
- Sara Tomassetti
- Department of Clinical and Experimental Medicine, University of Florence, Florence
-
- Antonella Caminati
- U.O. di Pneumologia, Ospedale San Giuseppe MultiMedica, IRCCS, Milano
-
- Edoardo Cavigli
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence
-
- Marco Albanesi
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence
-
- Fabio Melchiorre
- Department of Radiology, Sant’Andrea Hospital Vercelli, ASLVC
-
- Stefano Palmucci
- Radiodiagnostic and Radiotherapy Unit, Department of Medical Surgical Sciences and Advanced Technologies ‘GF Ingrassia’, University of Catania
-
- Virginia Vegni
- Radiology Unit, Rugani Hospital, Siena
-
- Serena Guiducci
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
-
- Alberto Moggi-Pignone
- Department of Experimental and Clinical Medicine, AOU Careggi Hospital, University of Florence Medical School, Florence, Italy
-
- Yannick Allanore
- Department of Rheumatology A, Descartes University, APHP, Cochin Hospital, Paris, France
-
- Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, and Infectious and Tropical Diseases Unit, AOUC
-
- Marco Confalonieri
- Department of Pulmonology, University Hospital of Cattinara, Trieste
-
- Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milano
-
- Francesco DeCobelli
- Department of Radiology IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University
-
- Amato dePaulis
- Division of Autoimmune & Allergic Diseases, Department of Translational Medical Sciences, University of Naples Federico II, Napoli
-
- Sergio Harari
- U.O. di Pneumologia, Ospedale San Giuseppe MultiMedica, IRCCS, Milano
-
- Dinesh Khanna
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
-
- Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan
-
- Gloria Taliani
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
-
- Federico Lavorini
- Department of Clinical and Experimental Medicine, University of Florence, Florence
-
- Vittorio Miele
- Department of Radiology, Azienda Ospedaliero-Universitaria Careggi, Florence
-
- Giovanni Morana
- Department of Radiology, Ca’ Foncello General Hospital, Treviso
-
- Alberto Pesci
- Respiratory Unit, University of Milano-Bicocca, S. Gerardo Hospital, Monza
-
- Carlo Vancheri
- Regional Referral Centre for Rare Lung Diseases, A. O. U. ‘Policlinico G. Rodolico—San Marco’ Department of Clinical and Experimental Medicine, University of Catania
-
- Stefano Colagrande
- Department of Experimental and Clinical Biomedical Sciences, Radiodiagnostic Unit n. 2, University of Florence—AOUC, Florence
-
- Marco Matucci-Cerinic
- Division of Rheumatology AOUC, Department of Clinical and Experimental Medicine, University of Florence, University of Florence
抄録
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>The aim of this study was to identify the main CT features that may help in distinguishing a progression of interstitial lung disease (ILD) secondary to SSc from COVID-19 pneumonia.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This multicentric study included 22 international readers grouped into a radiologist group (RADs) and a non-radiologist group (nRADs). A total of 99 patients, 52 with COVID-19 and 47 with SSc-ILD, were included in the study.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Fibrosis inside focal ground-glass opacities (GGOs) in the upper lobes; fibrosis in the lower lobe GGOs; reticulations in lower lobes (especially if bilateral and symmetrical or associated with signs of fibrosis) were the CT features most frequently associated with SSc-ILD. The CT features most frequently associated with COVID- 19 pneumonia were: consolidation (CONS) in the lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobes. After multivariate analysis, the presence of CONs in the lower lobes (P < 0.0001) and signs of fibrosis in GGOs in the lower lobes (P < 0.0001) remained independently associated with COVID-19 pneumonia and SSc-ILD, respectively. A predictive score was created that was positively associated with COVID-19 diagnosis (96.1% sensitivity and 83.3% specificity).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>CT diagnosis differentiating between COVID-19 pneumonia and SSc-ILD is possible through a combination of the proposed score and radiologic expertise. The presence of consolidation in the lower lobes may suggest COVID-19 pneumonia, while the presence of fibrosis inside GGOs may indicate SSc-ILD.</jats:p> </jats:sec>
収録刊行物
-
- Rheumatology
-
Rheumatology 61 (4), 1600-1609, 2021-07-28
Oxford University Press (OUP)