Pulmonary imaging findings of ANCA-associated vasculitis and its clinical characteristics / 实用放射学杂志

ABSTRACT

Objective To investigate the pulmonary imaging findings and the clinical characteristics of ANCA-associated vasculitis.Methods 16 patients with ANCA-associated vasculitis confirmed by pathology in our hospital were analyzed retrospectively,all patients underwent 1 6-sclice high resolution chest CT scans.The clinical manifestations and lung CT findings of the patients were analyzed.Results The mean age of 1 6 patients (7 male and 9 female)was 62.7 (ranged from 56 to 83).The onset time of the disease was ranged for 1 weeks to 2 years,and it was characterized as multiple organs involvement accompanied by kidney damage with different degrees.The clinical respiratory symptoms inluded fever and cough.The lung HRCT features of ANCA-associated vasculitis were as follows:patchy shadow in 14 cases (87.5%),streak one in 12 (75%),nodular one in 3 (18.8%),cavities in 4 (25%),emphysema and pulmonary bullae in 6 (37.5%),tree-in-bud in 6 (37.5%),pleural effusion in 4 (25%),mediastinal lymph nodes enlargement in 3 (18.8%), pleural thickening in 6 (37.5%),cellular-like in 5 (31.3%),bronchiectasis in 6 (37.5%),round-glass opacity in 10 (62.5%)and reticulate changes in 8 (50%).Some patients were treated by the glucocorticoid (a hormone steroid)or by it in combination with immunosuppressant, and the clinical symptoms were improved and some lesions on X-ray images were significantly reduced or disappeared.Conclusion ANCA-associated vasculitis usually occurs in the majority of middle or old age without gender difference.Multiple organs are easily involved and the lesions in lung may be misdiagnosed as infection.Early CT diagnosis and timely treatment may improve the prognosis.