Chest
Clinical Investigations: Idiopathic DiseasePulmonary Wegener's Granulomatosis: Correlation Between High-Resolution CT Findings and Clinical Scoring of Disease Activity
Section snippets
Patients
Seventy-three patients with WG (30 female, 43 male; mean age, 48.3 years; range, 34 to 71 years) underwent 98 staging examinations (1 examination each in 58 patients, 2 examinations in 8 patients, and ≥3 examinations in 7 patients). In the majority of enrolled patients, staging was performed for reevaluation after treatment (n=80 staging examinations). The diagnosis of WG was established in accordance to the 1990 American College of Rheumatology Criteria19 and the Chapel Hill criteria20 and it
Results
Correlations between HRCT findings and pulmonary status are presented in Table 2. HRCT detected nodules and masses in group 1 (active pulmonary disease) and group 2 (past pulmonary disease) only (Fig 1). There were significantly more patients with nodules/masses in group 1 (16/25 patients) compared with group 2 (9/45 patients) (p<0.001). The probability to have active lung disease is significantly increased in the event of nodules/masses (odds ratio 8.1, 95% confidence interval 2.7 to 27.9).
Discussion
Our study of 98 examinations in 73 patients with differing status of pulmonary disease documents a broad spectrum of radiologic signs. The classic pulmonary nodules and masses are found in merely 25% of examinations, which represents an incidence considerably lower compared with the literature.1, 10, 13, 14, 15, 17, 22 This discrepancy may be traced back to inclusion of patients with no overt pulmonary symptoms, subacute disease manifestation, and the chronic course of patients receiving
Acknowledgments
The authors thank Claus-C. Gluer, PhD (Section of Medical Physics, Department of Diagnostic Radiology) for his assistance with the statistical analysis.
References (32)
- et al.
Pulmonary Wegener's granulomatosis, a clinical and imaging study of 77 cases
Chest
(1990) - et al.
Granulomatous vasculitis, Wegener's granulomatosis and Churg-Strauss syndrome
Rheum Dis Clin North Am
(1990) - et al.
Imaging of thoracic Wegener's granulomatosis: the computed tomographic appearance
Am J Med
(1992) - et al.
Computed tomography of the lung in Wegener's granulomatosis
Clin Radiol
(1993) - et al.
Pulmonary lesions in Wegener's granulomatosis: a clinicopathologic study of 22 autopsy cases
Hum Pathol
(1986) - et al.
The pulmonary biopsy in the early diagnosis of Wegener's (pathergic) granulomatosis
Hum Pathol
(1988) - et al.
Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years
Ann Intern Med
(1983) - et al.
Wegener granulomatosis: an analysis of 158 patients
Ann Intern Med
(1992) - et al.
Clinical manifestations of Wegeners granulomatosis
APMIS Suppl
(1990) - et al.
Granulomatous vasculitides of the lung: a clinicopathologic approach to diagnosis and treatment
South Med J
(1989)