PATTERNS OF CLINICAL SYMPTOMS AND IMAGING IN INTERSTITIAL LUNG DISEASE: EVALUATING THE ROLE OF HRCT

Main Article Content

Dr. Priya Singh
Dr. Asit S. Natekar
Dr. Rohit Barne
Dr. VijayKumar S. Mane
Dr. Pradeep Raghavendra Kulkarni

Keywords

High-resolution computed tomography, rural health, respiratory symptoms, septal lines, ground-glass opacity

Abstract

OBJECTIVES:
To assess the clinical symptoms and radiological features of interstitial lung disease (ILD) in a tertiary care hospital, and to identify correlations between these clinical and imaging findings.


METHODS:
This cross-sectional study was conducted over 18 months, involving 30 ILD patients who underwent clinical evaluations and high-resolution computed tomography (HRCT) scans. Key clinical symptoms, including cough and dyspnea, were recorded, and radiological features such as septal lines and ground-glass opacities were analyzed. Radiological assessments were conducted using a Philips MX 16-slice CT scanner, and the data were analyzed using SPSS version 26.0. Correlational matrix analysis was employed to identify significant associations between clinical symptoms and radiological findings.


RESULTS:
Cough and dyspnea were the most frequent observed symptoms, with prevalence rates of 66.67% and 53.33%, respectively. HRCT revealed septal lines in 56.67% of cases and ground-glass opacities in 30%. A significant positive correlation was observed between dyspnea and ground-glass opacities (p < 0.05), suggesting that symptom severity may be associated with parenchymal changes on HRCT. The study provides an insight into ILD characteristics within a rural patient population, which may differ from urban cohorts.


CONCLUSIONS:
The study highlights common clinical and radiological patterns of ILD with notable correlations between specific symptoms and imaging findings. These findings accentuate the importance of HRCT in assessing ILD severity and may help tailor management strategies for healthcare providers. Further research with a larger sample and additional diagnostic tools is recommended to validate these results.

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References

1. Althobiani MA, Russell AM, Jacob J, Ranjan Y, Folarin AA, Hurst JR, Porter JC. Interstitial lung disease: a review of classification, etiology, epidemiology, clinical diagnosis, pharmacological and non-pharmacological treatment. Front Med (Lausanne). 2024 Apr 18;11:1296890. doi: 10.3389/fmed.2024.1296890.
2. Antoine MH, Mlika M. Interstitial Lung Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Updated 2023 Jul 31. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541084/
3. Raghu G, Mehta S. Interstitial lung disease (ILD) in India: Insights and lessons from the prospective, landmark ILD-India registry. Lung India. 2016 Nov-Dec;33(6):589-591. doi: 10.4103/0970-2113.192874. Lynch DA, Godwin JD, Safrin S, et al. High-resolution computed tomography in idiopathic pulmonary fibrosis: diagnosis and prognosis. Am J Respir Crit Care Med. 2005;172(4):488-493.
4. Kalchiem-Dekel O, Galvin JR, Burke AP, Atamas SP, Todd NW. Interstitial Lung Disease and Pulmonary Fibrosis: A Practical Approach for General Medicine Physicians with Focus on the Medical History. J Clin Med. 2018 Nov 24;7(12):476. doi: 10.3390/jcm7120476.
5. Cottin V, Hirani NA, Hotchkin DL, Nambiar AM, Ogura T, Otaola M, Skowasch D, Park JS, Poonyagariyagorn HK, Wuyts W, Wells AU. Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases. Eur Respir Rev. 2018 Dec 21;27(150):180076. doi: 10.1183/16000617.0076-2018.
6. Desai SR, Prosch H, Galvin JR. Plain Film and HRCT Diagnosis of Interstitial Lung Disease. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Chest, Breast, Heart and Vessels 2019-2022: Diagnostic and Interventional Imaging [Internet]. Cham (CH): Springer; 2019. Chapter 4. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553872/ DOI: 10.1007/978-3-030-11149-6_4
7. Maher TM, Wuyts W. Management of Fibrosing Interstitial Lung Diseases. Adv Ther. 2019 Jul;36(7):1518-1531. doi: 10.1007/s12325-019-00992-9. Epub 2019 May 22.
8. Lynch DA, Sverzellati N, Travis WD, et al. Diagnostic criteria for idiopathic pulmonary fibrosis: a Fleischner Society White Paper. Lancet Respir Med. 2018;6(2):138-153.
9. Lee H, Lee CH, Kim DK, et al. Early diagnosis of interstitial lung diseases via high-resolution CT scan: an essential tool in patient management. J Thorac Imaging. 2020;35(6):361-369.
10. Bonini M, Fiorenzano G. Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing. Eur Respir Rev. 2017 Mar;26(143):160099. doi: 10.1183/16000617.0099-2016.Maher TM, Wuyts W. Management of Fibrosing Interstitial Lung Diseases. Adv Ther. 2019 Jul;36(7):1518-1531. doi: 10.1007/s12325-019-00992-9.
11. Flaherty KR, Martinez FJ. Diagnosing interstitial lung disease: A practical approach to a difficult problem. Cleve Clin J Med. 2001 Jan;68(1):33-42. Maher TM, Wuyts W. Management of Fibrosing Interstitial Lung Diseases. Adv Ther. 2019 Jul;36(7):1518-1531. doi: 10.1007/s12325-019-00992-9.
12. Bonini M, Fiorenzano G. Exertional dyspnoea in interstitial lung diseases: the clinical utility of cardiopulmonary exercise testing. Eur Respir Rev. 2017 Mar;26(143):160099. doi: 10.1183/16000617.0099-2016.
13. Maller V, Foster T, Kang O, et al. Interlobular septal thickening. Reference article, Radiopaedia.org (Accessed on 16 Oct 2024) https://doi.org/10.53347/rID-5046
14. Gadre, A., Highland, K.B. Connective Tissue Related Interstitial Lung Disease. Curr Pulmonol Rep 7, 133–148 (2018). https://doi.org/10.1007/s13665-018-0212-5
15. Nakagawa H, Ogawa E, Fukunaga K, Kinose D, Yamaguchi M, Nagao T, Tanaka-Mizuno S, Nakano Y. Quantitative CT analysis of honeycombing area predicts mortality in idiopathic pulmonary fibrosis with definite usual interstitial pneumonia pattern: A retrospective cohort study. PLoS One. 2019 Mar 21;14(3)
16. Gaillard F, Yap J, Silverstone L, et al. Consolidation. Reference article, Radiopaedia.org (Accessed on 16 Oct 2024) https://doi.org/10.53347/rID-9226.
17. Rohit Sharma. Subpleural pulmonary nodules. Reference article, Radiopaedia.org [Internet]. Accessed on 12 Jul 2021. Available from: https://radiopaedia.org/articles/subpleural-pulmonary-nodules2
18. Han X, Chen L, Guo L, Wu L, Alwalid O, Liu J, Zheng Y, Chen L, Wu W, Li H, Luo Q, Zhao H, Zhang L, Bai Y, Sun B, Sun T, Gui Y, Nie T, Chen L, Yang F, Fan Y, Shi H, Zheng C. Long-term radiological and pulmonary function abnormalities at 3 years after COVID-19 hospitalisation: a longitudinal cohort study. Eur Respir J. 2024;64:2301612. doi: 10.1183/13993003.01612-2023.