Abnormal High-resolution Computed Tomography Findings Research Articles

Relationship between high-resolution computed tomography findings and the Stoke index in patients with rheumatoid arthritis

The aim of this study was to evaluate the relationship between high-resolution computed tomography (HRCT) findings and the Stoke index (SI) in patients with rheumatoid arthritis (RA). Forty RA patients (31 women, 9 men) were evaluated. All patients fulfilled the criteria proposed by the American College of Rheumatology. Clinical evaluation, haematological data, chest radiography, pulmonary function tests (PFTs) and HRCT were obtained in all patients. The SI was used to assess disease activity. In 17 (42.5%) patients, there were no signs of pulmonary involvement on HRCT; 23 (57.5%) of 40 patients had abnormal HRCT findings. Of 23 patients with HRCT abnormalities, six (two male, four female) had respiratory symptoms, four (one male, three female) had abnormalities on chest radiography and five (all female) had abnormalities on PFTs. There was no relationship between pulmonary changes observed on HRCT, clinical and laboratory disease activity parameters, chest X-ray and PFTs. There was no difference in the mean SI between patients included in the HRCT (+) and those included in the HRCT (-) groups. No significant correlations between the HRCT and the SI were seen. The main findings of this study are that HRCT can give useful information on RA-associated lung changes and that there was no relationship between the SI and the HRCT findings of patients with RA.

Abnormal radiological findings and a decreased carbon monoxide transfer factor can persist long after the acute phase of Legionella pneumophila pneumonia.

Pulmonary abnormalities may persist long after the acute phase of legionnaires disease (LD). In a cohort of 122 survivors of an outbreak of LD, 57% were still experiencing an increased number of symptoms associated with dyspnea at a mean of 16 months after recovery from acute-phase LD. For 86 of these patients, additional evaluation involving high-resolution computed tomography (HRCT) of the lung revealed pulmonary abnormalities in 21 (24%); abnormal HRCT findings generally presented as discrete and multiple radiodensities. Residual pulmonary abnormalities were associated with a mean reduction of 20% in the gas transport capacity of the lung. This latter sign could not be used to explain the increased symptoms of dyspnea reported by patients. Receipt of mechanical ventilation during the acute phase of LD, delayed initiation of adequate antibiotic therapy, and chronic obstructive pulmonary disease were identified as risk factors for the persistence of lung abnormalities.

Late abnormal findings on high-resolution computed tomography after Mycoplasma pneumonia.

The clinical course of Mycoplasma pneumonia is typically mild and self-limited. There are, however, several case reports of severe complication following this illness with considerable morbidity and mortality. This study was conducted to investigate, using high-resolution computed tomography (HRCT), the long-term pulmonary structural abnormalities after Mycoplasma pneumonia and to identify risk factors (chest radiograph findings, antibody titers, and host factors) that might increase the likelihood of developing the sequelae. Thirty-eight children requiring hospitalization attributable to Mycoplasma pneumonia were recruited by the retrospective examination of hospital records. They underwent HRCT after an interval of 1.0 to 2. 2 years. A control group of 17 children with the history of Mycoplasma upper respiratory infection was also studied after a similar interval. Abnormal HRCT findings were present in 37% (14/38) of the pneumonia group, compared with 12% (2/17) of the control group. The abnormalities in the pneumonia group, which appeared alone or in combination, included mosaic perfusion (n = 12), bronchiectasis (n = 8), bronchial wall thickening (n = 4), decreased vascularity (n = 1), and air trapping on expiratory scan (9 of 29 tested). The area affected by these abnormalities, usually involving 2 or more lobes, corresponded in all cases to the location of the infiltrate on chest radiograph at the time of pneumonia. Between subjects with abnormal HRCT (n = 14) and normal HRCT (n = 24) in the pneumonia group, significant differences were observed in age at the time of pneumonia (mean +/- standard deviation: 5.3 +/- 2. 0 years vs 7.7 +/- 3.4 years) and peak antimycoplasma antibody titer (geometric mean [range of 1 standard deviation]; 1:7943 [3126-19 953] vs 1:3093 [832-11 482]). We conclude that a considerable proportion of children with history of Mycoplasma pneumonia have abnormal findings on HRCT, suggestive of small airway obstruction and that younger age and higher antibody titer at the time of pneumonia may be risk factors for these sequelae.