Chest high-resolution computed tomography can make higher accurate stages for thoracic sarcoidosis than X-ray

Zhang, Yuan; Du, Shan-Shan; Zhao, Mengmeng; Li, Qiu-hong; Zhou, Ying; Song, Jia-Cui; Chen, Tao; Shi, Jingyun; Jie, Bing; Li, Wei; Shen, Li; Zhang, Fen; Su, Yucai; Hu, Yang; Lower, Elyse E.; Baughman, Robert P.; Li, Huiping

doi:10.1186/s12890-022-01942-y

Cited by 9 publications

(2 citation statements)

References 18 publications

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“…Chest CT is probably the most frequently used imaging test in sarcoidosis screening at present, supplanting chest X-rays [105]. Parenchymal lung abnormalities consistent with sarcoidosis are now included in the IWOS criteria for ocular sarcoidosis, provided that imaging is reviewed by specialized pulmonologists or radiologists [51].…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Sarcoidosis-Related Uveitis: A Review

Giorgiutti

Jacquot

Jammal

et al. 2023

JCM

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Sarcoidosis is an inflammatory disease that involves the eyes in 10–55% of cases, sometimes without systemic involvement. All eye structures can be affected, but uveitis is the most common ocular manifestation and causes vision loss. The typical ophthalmological appearance of these uveitis is granulomatous (in cases with anterior involvement), which are usually bilateral and with synechiae. Posterior involvement includes vitritis, vasculitis and choroidal lesions. Tuberculosis is a classic differential diagnosis to be wary of, especially in people who have spent time in endemic areas. The diagnosis is based on histology with the presence of non-caseating epithelioid granulomas. However, due to the technical difficulty and yield of biopsies, the diagnosis of ocular sarcoidosis is often based on clinico-radiological features. The international criteria for the diagnosis of ocular sarcoidosis have recently been revised. Corticosteroids remain the first-line treatment for sarcoidosis, but up to 30% of patients require high doses, justifying the use of corticosteroid-sparing treatments. In these cases, immunosuppressive treatments such as methotrexate may be introduced. More recent biotherapies such as anti-TNF are also very effective (as they are in other non-infectious uveitis etiologies).

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Section: Imaging Modalitiesmentioning

confidence: 99%

Sarcoidosis-Related Uveitis: A Review

Giorgiutti

Jacquot

Jammal

et al. 2023

JCM

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“…4 The findings of a CXR are usually non-specific and lack sensitivity due to inherent limitation of not being able to visualize the mediastinum. 14,17 Therefore, a normal CXR does not exclude a diagnosis of ILD. 12 They still can aid to rule out other conditions like left heart failure, pulmonary metastasis etc.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Chest Radiograph in Interstitial Lung Disease as Confirmed by High-Resolution Computed Tomography (Hrct) Chest

Akram

Hussain²,

Azmat³

et al. 2022

J Ayub Med Coll Abbottabad

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Background: Interstitial Lung Disease (ILD) - an umbrella term encompassing about 100 different pathophysiological entities are usually defined as an irreversible, progressive fibrotic changes in the lung parenchyma that leads to difficult breathing and reduced gaseous exchange at the alveolar level. We aimed to quantify the validity of CXR for the diagnosis of ILD taking HRCT as gold standard in the population of Hazara division. Methods: This validation study was conducted during 11 June till 12 Dec 2019 in the radiology department of Ayub Teaching Hospital, Abbottabad on 60 adult patients aged 30–60 years who presented with progressive exertional dyspnoea. The patients were enrolled into the study via non-probability, consecutive sampling technique. All the data was recorded on a self-developed structured questionnaire. Data was analyzed using SPSS version 20. Results: The mean age of study participants was 47.18±6.90 years SD with a range of 36–60years. The mean of time duration of symptoms was 9.66±1.7 years with a range of 7–12 years. There were 40 (66.7%) males and 20 (33.3%) females with a male to female ratio of 2:1. The sensitivity, specificity, PPV, NPV and Diagnostic Accuracy of CXR for the diagnosis of ILD as compared to HRCT was calculated to be 65.5%, 20%, 90%, 5% and 61.66% respectively. A chi square test of significance yielded a value of 0.51 for the diagnostic accuracy of CXR for ILD as compared to HRCT. Diagnostic ODDs ratio and Youden’s Index yielded values of 47.37% and 0.145 respectively. All these parameters’ points towards a lower utility of CXR for the diagnostic purpose in patients suspected with ILD. Conclusion: Chest x-ray is simple, non-invasive, economical and readily available alternative to HRCT but its specificity and diagnostic accuracy are questionable. CXR is a recommendable first line investigation for chest pathology workup but for a definitive diagnosis, one should not depend on CXR as it can miss the diagnosis.

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