Chest high-resolution computed tomography can make higher accurate stages for thoracic sarcoidosis than X-ray

BMC Pulmonary Medicine

Robert P. Baughman¹  Elyse E. Lower¹  Bing Jie²  Wei Li²  Jing-yun Shi²  Fen Zhang³  Huiping Li³  Yang Hu³  Tao Chen³  Qiu-hong Li³  Ying Zhou³  Meng-meng Zhao³  Jia-cui Song³  Li Shen³  Yi-liang Su³  Yuan Zhang³  Shan-shan Du³ 

[1]Department of Internal Medicine, University of Cincinnati Medical Center

[2]Department of Radiology, School of Medicine, Shanghai Pulmonary Hospital, Tongji University

[3]Department of Respiratory Medicine, School of Medicine, Shanghai Pulmonary Hospital, Tongji University

关键词: Sarcoidosis;    Pulmonary;    Chest x-ray;    High-resolution computed tomography;    Pleural involvement;   

DOI  :  10.1186/s12890-022-01942-y

来源: DOAJ

【 摘 要 】

Abstract Background To explore if chest high-resolution computed tomography (HRCT) can make higher accurate stages for thoracic sarcoidosis stage than X-ray (CRX) only. Methods Clinical data from medical records of consecutive patients with a confirmed diagnosis of pulmonary sarcoidosis at Shanghai Pulmonary Hospital from January 1 2012 to December 31 2016 and consecutive patients treated at the Sarcoidosis Center of University of Cincinnati Medical Center, Ohio, USA from January 1 2010 to December 31 2015 were reviewed. The clinical records of 227 patients diagnosed with sarcoidosis (140 Chinese and 87 American) were reviewed. Their sarcoidosis stage was determined by three thoracic radiologists based on CXR and HRCT presentations, respectively. The stage determined from CXR was compared with that determined from HRCT. Results Overall, 50.2% patients showed discordant sarcoidosis stage between CXR and HRCT (52.9% in Chinese and 44.8% in American, respectively). The primary reason for inconsistent stage between CXR and HRCT was failure to detect mediastinal lymph node enlargement in the shadow of the heart in CXR (22.1%) and small nodules because of the limited resolution of CXR (56.6%). Stage determined from HRCT negatively correlated with carbon monoxide diffusing capacity (DLCO) significantly (P < .01) but stage determined from CXR did not. Pleural involvement was detected by HRCT in 58 (25.6%) patients but only in 17 patients (7.5%) by CXR. Patients with pleural involvement had significantly lower forced vital capacity and DLCO than patients without it (both P < .05). Conclusion Revised staging criteria based on HRCT presentations included 5 stages with subtypes in the presence of pleural involvement were proposed. Thoracic sarcoidosis can be staged more accurately based on chest HRCT presentations than based on CXR presentations. Pleural involvement can be detected more accurately by HRCT.

【 授权许可】

Unknown