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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Rheumatology+(Oxford) 2022 ; 61 (4): 1600-1609 Nephropedia Template TP
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The role of chest CT in deciphering interstitial lung involvement: systemic sclerosis versus COVID-19 #MMPMID34320649
Orlandi M; Landini N; Sambataro G; Nardi C; Tofani L; Bruni C; Bellando-Randone S; Blagojevic J; Melchiorre D; Hughes M; Denton CP; Luppi F; Ruaro B; Della Casa F; Rossi FW; De Luca G; Campochiaro C; Spinicci M; Zammarchi L; Tomassetti S; Caminati A; Cavigli E; Albanesi M; Melchiorre F; Palmucci S; Vegni V; Guiducci S; Moggi-Pignone A; Allanore Y; Bartoloni A; Confalonieri M; Dagna L; DeCobelli F; dePaulis A; Harari S; Khanna D; Kuwana M; Taliani G; Lavorini F; Miele V; Morana G; Pesci A; Vancheri C; Colagrande S; Matucci-Cerinic M
Rheumatology (Oxford) 2022[Apr]; 61 (4): 1600-1609 PMID34320649show ga
OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
Rheumatology+(Oxford) 2022 ; 61 (4): 1600-1609
