Affiliations: [a]
School of Medical Technology, Shaanxi University of Chinese Medicine, Xian Yang, China
| [b]
Department of Rheumatology Immunohematology, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xian Yang, China
| [c]
Department of Medical Imaging, Affiliated Hospitalof Shaanxi University of Chinese Medicine, Xian Yang, China
Correspondence:
[*]
Corresponding author: Nan Yu, Department of Medical Imaging, Affiliated Hospital of Shaanxi University of Chinese Medicine, 2 Weiyang Western Road, Xian Yang 712000, China Tel.: +86 13891955922 Fax: +86 029 33327027 E-mail: [email protected].
Abstract: OBJECTIVE: To explore the application of quantitative computed tomography (CT) in analyses of lung changes in patients with rheumatoid arthritis (RA). METHODS: A total of 150 clinically diagnosed RA patients underwent chest CT and 150 matched non-smokers subjects with normal chest CT are enrolled. A CT software is applied to analyze CT obtained from both groups. The quantitative indices of emphysema are expressed as the percentage of lung area with attenuation < –950HU to the total lung volume (LAA–950%), and pulmonary fibrosis was expressed as the percentage of lung area with a attenuation of –200 to –700HU to the total lung volume (LAA–200––700%), quantitative indicators of pulmonary vascular include aortic diameter (AD), pulmonary artery diameter (PAD), the ratio of PAD to AD (PAD/AD ratio), the number of blood vessels (TNV), and the cross area of blood vessels (TAV). The receiver operating characteristic (ROC) curve is used to evaluate the ability of these indexes in identifying the changes in the lung in RA patients. RESULTS: Compared to the control group, the RA group has significantly lower TLV, larger AD, and smaller TNV and TAV (3921±1101 vs. 4490±1046, 33.26±4.20 vs. 32.95±3.76, 13.14±4.93 vs. 17.53±3.34, and 96.89±40.62 vs. 163.32±34.97, respectively, with all p < 0.001). Peripheral vascular indicator TAV has the better ability to identify lung changes in RA patients (area under ROC curve AUC = 0.894) than TNV (AUC = 0.780) or LAA–200 &sim–700% (AUC = 0.705). CONCLUSION: Quantitative CT can detect changes in lung density distribution and peripheral vascular injury in patients with RA and assess the severity.
