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THE ROLE OF CHEST CT IN DECIPHERING INTERSTITIAL LUNG INVOLVEMENT: SYSTEMIC SCLEROSIS VERSUS COVID-19

Martina Orlandi, Nicholas Landini, Gianluca Sambataro, Cosimo Nardi, Lorenzo Tofani, Cosimo Bruni, Silvia Bellando- Randone, Jelena Blagojevic, Daniela Melchiorre, Michael Hughes, Christopher P Denton, Fabrizio Luppi (+33 others)
2021 Rheumatology  

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https://web.archive.org/web/20210730001935/https://watermark.silverchair.com/keab615.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAvcwggLzBgkqhkiG9w0BBwagggLkMIIC4AIBADCCAtkGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMkVU1hY7p3QguksrfAgEQgIICqgLamB91U8ZtZ7RpwVOexzQ5TeSYOcuNPLrtYfx9nXQYaH-qXBHABRdy60FcIiRTsDb97OJ9D-jHkep0iQtnpeZz39u3SAUbT0v8Oiw8q2IoTmrG42cj4e1PpESzmPvJzAcT1GzF0q5w2-_M0aOS0NOoU567auGKYnTGhQ3hs0AyqRIXbyT12L2tVvtpfl85Q05GYxCVBTUwNZWmTMVndAWD6lQrjlAWt6l5XqbYfLjjlcYR2l3qk4Xq7Hzh9DaJZKiAI5yeE4Unda5wVcm3gZehD-D9lQHWVrxN8mMKcrcUnyBOE2wL7YnYNZ7x0VXayUZEV46bTl0sFl10ICd1OXXcm-4SbFNJF-LqngoejuAYbA8VhkBg0MUV3sGSAiD7DlZ2oJAg7MzkjKhQxsw4n3K_Y4DDH6tvuzCIlPJGv8YgNv0BBAptEb2ayD2f4UwvKKX3vpcAbEu3Uovll1ncm96rbRPybPVfeAZPiQmR_GZtYpi0kSqn9LHXTlw-sV4QIwX4BIRTsgBg1LDur0_b2TSuRdbdl7ydDU8e2GKw355zn-ee1GMjQQX0nRM2i0rMqQtr_vKZm2JdVNyhdRCOblIQRc4-dO1AO0vA8F5-egupeW_kXU6LcX8qL-0Zoey4iRuitI31CXA7fBT0CNvMYPCcQuI1J8X4gjXMdPGE-xvicqf0vMc4sSFT4Vz2WbXKZogflAOkolSEZ4-wIRV5TUf537VOM8ztYyo4Uz_Aa6pEX_eTlfkTcxfIZzgH4ESwu0mYT-hKYACrL844KBFnvPov2UltSNdoB8Wa5mcGjbKESCL9T5Oxv77tJWOqA1yIZ8gCISmTwuAb8V0Y06r3X0aR-g7aovNVCHGOqJz8XCqPirh_XODvyf95b8VOKABLzMb9DLMtgokRUt8

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Objective To identify the main computed tomography (CT) features that may help distinguishing a progression of interstitial lung disease (ILD) secondary to Systemic sclerosis (SSc) from COVID-19 pneumonia. Methods This multicentric study included 22 international readers divided in the radiologist group (RAD) and non-radiologist group (nRAD). A total of 99 patients, 52 with COVID-19 and 47 with SSc-ILD, were included in the study. Results Fibrosis inside focal ground glass opacities (GGO) in
more » ... upper lobes; fibrosis in the lower lobe GGO; reticulations in lower lobes (especially if bilateral and symmetrical or associated with signs of fibrosis) were the CT features most frequently associated with SSc-ILD. The CT features most frequently associated with COVID- 19 pneumonia were: consolidation (CONS) in the lower lobes, CONS with peripheral (both central/peripheral or patchy distributions), anterior and posterior CONS and rounded-shaped GGOs in the lower lobes. After multivariate analysis, the presence of CONS in the lower lobes (p < 0.0001) and signs of fibrosis in GGO in the lower lobes (p < 0.0001) remained independently associated with COVID-19 pneumonia or SSc-ILD, respectively. A predictive score was created which resulted positively associated with the COVID-19 diagnosis (96.1% sensitivity and 83.3% specificity). Conclusion The CT differential diagnosis between COVID-19 pneumonia and SSc-ILD is possible through the combination the proposed score and the radiologic expertise. The presence of consolidation in the lower lobes may suggest a COVID-19 pneumonia while the presence of fibrosis inside GGO may indicate a SSc-ILD.
doi:10.1093/rheumatology/keab615 pmid:34320649 fatcat:cijmyyqxvvcc7h3ublm6qgfu3m
Citation

Martina Orlandi, Nicholas Landini, Gianluca Sambataro, Cosimo Nardi, Lorenzo Tofani, Cosimo Bruni, Silvia Bellando- Randone, Jelena Blagojevic, Daniela Melchiorre, Michael Hughes, Christopher P Denton, Fabrizio Luppi, Barbara Ruaro, Francesca della Casa, Francesca W Rossi, Giacomo De Luca, Corrado Campochiaro, Michele Spinicci, Lorenzo Zammarchi, Sara Tomassetti, Antonella Caminati, Edoardo Cavigli, Marco Albanesi, Fabio Melchiorre, Stefano Palmucci, Virginia Vegni, Serena Guiducci, Alberto Moggi-Pignone, Yannick Allanore, Alessandro Bartoloni, Marco Confalonieri, Lorenzo Dagna, Francesco De Cobelli, Amato De Paulis, Sergio Harari, Dinesh Khanna, Masataka Kuwana, Gloria Taliani, Federico Lavorini, Vittorio Miele, Giovanni Morana, Alberto Pesci, Carlo Vancheri, Stefano Colagrande, Marco Matucci-Cerinic. "THE ROLE OF CHEST CT IN DECIPHERING INTERSTITIAL LUNG INVOLVEMENT: SYSTEMIC SCLEROSIS VERSUS COVID-19." Rheumatology 61.4 (2021) 1600-1609