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Idiopathic Nonspecific Interstitial Pneumonia: Changes in High-Resolution Computed Tomography on Long-Term Follow-Up

Kim, Mi-Young MD, PhD; Song, Jin Woo MD; Do, Kyung-Hyun MD; Jang, Se Jin MD; Colby, Thomas V. MD; Kim, Dong Soon MD

Journal of Computer Assisted Tomography: March/April 2012 - Volume 36 - Issue 2 - p 170–174
doi: 10.1097/RCT.0b013e31823ed437
Thoracic Imaging

Objective: This study aimed to assess the change in findings of nonspecific interstitial pneumonia (NSIP) from high-resolution computed tomography (HRCT) on long-term follow-up (median, 38 months).

Materials and Methods: A retrospective review of changes in HRCT in 68 patients with NSIP (fibrotic progression, 61) with follow-up HRCT of at least 1-year interval was conducted.

Results: Follow-up HRCT findings showed a decreased extent of ground-glass opacity and consolidation, with increased honeycombing, traction bronchiectasis, and architectural distortion (all P < 0.05). Radiological improvement was seen in 36%, stability was seen in 23%, and fibrotic progression was seen with recurrence in 13% and without recurrence in 28%. In 3 patients (4.9%), HRCT converted to a definite usual interstitial pneumonia pattern. Honeycombing and reticulation were independent predictors for mortality in fibrotic NSIP (P < 0.01).

Conclusions: Although most of the follow-up HRCT scans showed improvement in the extent of ground-glass opacity and consolidation, approximately one third showed fibrotic progression or recurrence, with transition from NSIP to definite usual interstitial pneumonia pattern.

From the Departments of *Radiology, †Pulmonary and Critical Care Medicine, and ‡Pathology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, South Korea; and §Department of Pathology, Mayo Clinic, Scottsdale, AZ.

Received for publication July 21, 2011; accepted October 25, 2011.

Reprints: Dong Soon Kim, MD, Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, 388-1, Pungnap-2dong, Songpa-gu, Seoul, South Korea (e-mail: dskim@amc.seoul.kr).

The authors report no conflicts of interest.

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