Dados do Trabalho

Título

CHEST MRI WITH CT IN THE ASSESSMENT OF INTERSTITIAL LUNG DISEASE PROGRESSION IN PATIENTS WITH SYSTEMIC SCLEROSIS

Introdução

Introduction and objective: To describe the performance of computerized tomography (CT) and magnetic resonance imaging (MRI) in the assessment of interstitial lung disease's (ILD) progression associated with systemic sclerosis (SSc) and demonstrate the MRI's correlations with pulmonary function test (PFT) and CT scores.

Casuística e Métodos

Material and methods:​ This prospective single-centre observational study included patients with SSc diagnoses, and MRI images were assessed visually using the Scleroderma Lung Study I system. Differences in the median scores were assessed with Student’s t-test and the Wilcoxon rank-sum test. Pearson’s and Spearman’s rank correlation coefficients were calculated to correlate imaging scores and PFT results. Using disease progression as the gold standard, we calculated the area under the curve (AUC) of the CT and MRI scores with Harrel’s c-index. The best thresholds for the prediction of disease progression were determined by receiver operating characteristic curve analysis with maximum Youden’s Index (P<0.05). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the scores were calculated.

Resultados

Results and discussion:​ The AUCs for MRI and CT scores were 0.86 (0.72-0.98; P=0.04) and 0.83 (0.70-0.99; P=0.05), respectively. CT and MRI scores correlated with forced vital capacity (MRI: r=-0.54, P=0.0045; CT: r=-0.44; P=0.137) and diffusing capacity of the lung for carbon monoxide (MRI: r=-0.39, P=0.007; CT r=-0.36, P=0.006). The sensitivity, specificity, PPV and NPV were 85%, 87.5%, 88.34% and 86.11% (MRI score) and 84.21%, 82.35%, 84.14% and 82.4% (CT score), respectively.

Conclusões

Conclusions: MRI scores from patients with SSc may be an alternative modality for the assessment of ILD progression in patients with SSc.

Palavras Chave

Key-words: interstitial lung disease, CT, MRI, SSc.