Korean J Radiol.  2005 Sep;6(3):143-152. 10.3348/kjr.2005.6.3.143.

Usual Interstitial Pneumonia and Non-Specific Interstitial Pneumonia: Serial Thin-Section CT Findings Correlated with Pulmonary Function

• Jeong YJ
• Lee KS
• Muller NL
• Chung MP
• Chung MJ
• Han J
• Colby TV
• Kim S

• KMID: 1102710
• DOI: http://doi.org/10.3348/kjr.2005.6.3.143

Abstract

OBJECTIVE
We wanted to demonstrate and compare the serial high-resolution CTs (HRCT) and the pulmonary function test (PFT) findings of the usual interstitial pneumonia (UIP) and the non-specific interstitial pneumonia (NSIP). MATERIALS AND METHODS: The serial HRCT scans and the PFT results were retrospectively analysed and compared for 35 patients having UIP without significant honeycombing (UIP-w/o hc, < 5% of honeycombing at CT), 35 patients having UIP with honeycombing (UIP-w/i hc, > or = 5% of honeycombing), and 25 patients with NSIP. The mortality rates were also compared. Follow-up CT scans were available in 75 patients (29 UIP-w/o hc patients, 22 UIP-w/i hc patients and 24 NSIP patients) and the follow-up periods ranged from 150 to 2, 370 days. The initial and follow-up PFT data were available for 71 patients. RESULTS: On the initial CT, significant differences were present between the UIP-w/i hc patients and both the UIP-w/o hc patients and the NSIP patients in the overall extent, ground-glass opacity (GGO) away from the reticulation, reticulation and honeycombing (all p < 0.05). Improvement was noticed in five (17%) of 29 UIP-w/o hc patients, none of 22 UIP-w/i hc patients, and 9 (37%) of 24 NSIP patients; deterioration was noted in six (21%) UIP-w/o hc patients, two (9%) UIP-w/i hc patients and three (13%) NSIP patients (p = 0.044 between UIP-w/o and UIP-w/i hc; p = 0.637 between UIP-w/o hc and NSIP; p = 0.007 between UIP-w/i hc and NSIP). The serial changes of the pulmonary function in the NSIP patients were different from those noted for the UIP-w/i hc and UIP-w/o hc patients (p = 0.440 between UIP-w/o and UIP-w/i hc; p = 0.022 between UIP-w/o hc and NSIP; p = 0.003 between UIP-w/i hc and NSIP). Five (14%) of the 35 patients with UIP-w/o hc, 16 (46%) of the 35 patients with UIP-w/i hc and three (12%) of the 25 patients with NSIP died (p = 0.002, comparison for the three groups). CONCLUSION: On CT, NSIP and UIP-w/o hc patients have similar patterns of parenchymal abnormalities and a similar likelihood of change in the extent of disease on follow-up. Patients with UIP-w/i hc have distinctive features and a worst prognosis.

Keyword

Lung, CT; Lung, diseases; Lung, fibrosis; Lung, interstitial disease; Pneumonia, usual interstitial; Pneumonia, non-specific interstitial and fibrosis

MeSH Terms

*Tomography, X-Ray Computed
Retrospective Studies
Lung Diseases, Interstitial/mortality/*physiopathology/*radiography
Lung/*physiopathology
Humans
Follow-Up Studies
Female
Aged

Figure

• 

  Fig. 1 Usual interstitial pneumonia without significant honeycombing in a 54-year-old man. A, B. Lung window of the transaxial high-resolution (1.0-mm collimation) CT scans obtained at the levels of the inferior pulmonary vein (A) and the liver dome (B), respectively, show patchy ground-glass opacity, reticulation, and a little honeycombing in the subpleural areas and in the posterior aspect of both lower lobes (total extent; 34% of the lung volume, ground-glass opacity; 24%, reticulation; 8%, honeycombing; 2%). C, D. CT scans obtained at similar levels to A and B and at four and half years later show the decreased extent of the overall parenchymal abnormalities, but the increased extent of honeycombing and reticulation (total extent; 24% of the lung volume, ground-glass opacity; 7%, reticulation; 11%, honeycombing; 6%).

• 

  Fig. 2 Usual interstitial pneumonia with honeycombing in a 63-year-old man. A, B. Lung window of transaxial hiph-resolution (1.0-mm collimation) CT scans obtained at the levels of inferior pulmonary vein (A) and the liver dome (B), respectively, show patchy ground-glass opacity, reticulation and honeycombing in the subpleural area and in the posterior aspect of both lower lobes (total extent; 27% of lung volume, ground-glass opacity; 10%, reticulation; 5%, honeycombing; 12%). C, D. CT scans obtained at similar levels to A and B and four years later show little change in extent of the parenchymal abnormalities (total extent; 30% of lung volume, ground-glass opacity; 10%, reticulation; 5%, honeycombing; 15%).

• 

  Fig. 3 Non-specific interstitial pneumonia in a 73-year-old woman. A, B. Lung window of the transaxial hiph-resolution (1.0-mm collimation) CT scans obtained at the levels of the inferior pulmonary vein (A) and the liver dome (B), respectively, show extensive patchy ground-glass opacity, consolidation and reticulation in both lungs (total extent; 45% of lung volume, ground-glass opacity; 30%, consolidation; 7%, reticulation; 8%). Also note the traction bronchiectasis (arrows). C, D. CT scans obtained at similar levels to A and B and five years later show the decreased extent of the parenchymal abnormalities (total extent; 20% of lung volume, ground-glass opacity; 12%, reticulation; 8%).

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