Comparison of circulatory disorders in the lungs revealed by X-ray and single-photon emission computed tomography with articular changes in magnetic resonance imaging in patients with rheumatoid arthritis

Abstract

Introduction. Rheumatoid arthritis (RA) affects not only the joints but also other organs. Lung disease is one of the leading manifestations of RA, and detection of these changes remains a diagnostic challenge. Delayed diagnosis of pulmonary involvement in the pathogenesis of RA often leads to development of severe forms which aggravate prognosis and decrease of the quality of life. Identify the characteristics and prognostic significance of CT and SPECT symptoms involving respiratory system in patients with RA depending on the stage of the disease and the destruction of hand joints as detected by MRI. Methods. To evaluate favorable and unfavorable predictors of RA clinical course and detect changes in the lung using modern methods of imaging: magnetic resonance, computed tomography and single-photon emission computed tomography. Results. A set of signs identified by CT and SPECT was analyzed corresponding to the presence of different types of erosions detected by MRI. Pleural adhesions, symptoms of bronchial obstruction (uneven ventilation, «air trap»), and signs of vasculitis were observed in all stages of the disease. With the progression of the disease, bullous emphysema-type deforming bronchitis symptoms and associated comorbid processes in the lung tissue were observed. Conclusions. For all types of active RA in patients with a high frequency revealed signs of bronchial obstruction and concomitant manifestations of vasculitis. These results require the inclusion of X-ray and single photon emission computed tomography of the chest in the algorithm of diagnostic evaluation of the patients with RA to identify and assess changes related primarily to the blood circulation, have prognostic significance and impact on treatment regimen.