Relationship between HRCT changes and clinical parameters in patients with scleroderma

Abstract

Introduction: Systemic sclerosis (SS), the most severe form of scleroderma, can lead to degeneration of the connective tissue in the lung, which is one of the most frequently involved organ related to this process. The extent of the lung involvement can be assessed in the high resolution CT (HRCT), which has important relevance in the prognosis and therapy. The aim of this study was to assess the relationship between visible changes in the HRCT and clinical parameters such as lung function and serology. Methods: 34 SS patients with abnormal lung functions or X-ray images were selected to undergo an HRCT between January 2014 and September 2017. All HRCT image has been scored for the intensity of ground glass opacity (GGO), lung fibrosis, bronchiectasis and honeycombing. Additional parameters like vascular diameters and lung volume have been calculated. These radiological parameters have been compared to clinical parameters of the lung function (FVC, FEV1, TLCO, KLCO) and the serology (anti-nuclear antibody, ANA). Results: A significant association between morphological changes in the HRCT and lung volume was found (3919± 989 liters, p=0.011), as well as an association between the total lung volume and fibrosis (p=0.090). ANA showed a very strong correlation with GGOs (p=0.009) and a borderline correlation with the HRCT score (p=0.059). Conclusion: HRCT was a very useful method for the diagnosis of interstitial lung fibrosis in scleroderma patients. The lung volume was associated with the extension of interstitial lung disease and fibrosis. The extension of alveolitis showed association with ANA and HRCT score, therefore, it might be useful in the quantification of the disease.