The Relevance of High-Resolution Computed Tomographic
Findings and Pulmonary Arterial Hypertension in
Systemic Sclerosis-Associated Interstitial Lung Disease
Suparaporn Wangkaew MD*, Juntima Euathrongchit MD**,
Sumawadee Patiwetwitoon MD*, Narawudt Prasertwitayakij MD***,
Nuntana Kasitanon MD*, Worawit Louthrenoo MD*
Affiliation :
* Division of Rheumatology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
** Division of Diagnostic Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
*** Division of Cardiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Objective : To compare the high-resolution computed tomographic (HRCT) findings between systemic sclerosis-associated
interstitial lung disease (SSc-ILD) with and without pulmonary arterial hypertension (PAH), as well as to correlate the
calculated HRCT scores and the estimated systolic pulmonary artery pressure (sPAP).
Material and Method: The medical records of all SSc-ILD patients who presented at the Rheumatology Clinic, Chiang Mai
University Hospital were retrospectively reviewed. Patients with the availability of echocardiography performed within
six months of the corresponding HRCT were included. The extent of ground glass, lung fibrosis, and honeycombing were
scored. The maximum diameter of the main pulmonary artery (MPAD) and ascending aortic diameter (AD) were measured.
The PAH was defined by sPAP ≥45 mmHg.
Results : Fifty patients with SSc-ILD diagnosed with HRCT were included. Echocardiography identified 19 (38.0%) patients
with PAH. The SSc-ILD with PAH had significantly higher mean (SD) lung fibrosis (9.9 [3.6] vs. 7.8 [3.5], p = 0.03), and
CT-total scores (20.5 [6.9] vs. 14.9 [6.2], p<0.01) than those without PAH. In the total group, the CT-total score correlated
positively with sPAP (r = 0.384, p<0.01). No significant correlation of MPAD or MPAD/AD with sPAP was found.
Conclusion : SSc-ILD with PAH had more severe lung fibrosis than those without PAH. The calculated total HRCT score
may be useful to identify PAH in SSc-ILD.
Keywords : High resolution computed tomography (HRCT), Systemic sclerosis (SSc), Echocardiography, Interstitial lung
disease (ILD), Pulmonary arterial hypertension (PAH)
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