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(Chest. 2005;127:185-191.)
© 2005 American College of Chest Physicians

Long-term Follow-up CT Scan Evaluation in Patients With Pulmonary Sarcoidosis*

Masanori Akira, MD; Takenori Kozuka, MD; Yoshikazu Inoue, MD and Mitsunori Sakatani, MD, FCCP

* From the Departments of Radiology (Drs. Akira and Kozuka) and Internal Medicine (Drs. Inoue and Sakatani), National Hospital Organization, Kinki-chuo Chest Medical Center (former National Kinki Chuo Hospital for Chest Diseases), Sakai City, Osaka, Japan.

Correspondence to: Mitsunori Sakatani, MD, FCCP, Department of Internal Medicine, National Hospital Organization, Kinki-chuo Chest Medical Center, 1180 Nagasone-cho, Sakai City, Osaka 591-8555, Japan; e-mail: Akira{at}kch.hosp.go.jp

Objectives: The aim of the present study was to determine how the pattern and extent of sarcoidosis changes over time on serial high-resolution CT (HRCT) scans and to identify CT scan findings that might be helpful in predicting the prognosis of patients with the disease.

Methods: The initial and last HRCT scan findings of 40 patients with pulmonary sarcoidosis during a mean follow-up period of 7.4 years (range, 3 to 18 years) were evaluated retrospectively. HRCT scan findings then were correlated with the pulmonary function tests.

Results: Parenchymal abnormalities in most patients with a predominant nodular pattern (18 patients) and multiple large nodular pattern (8 patients) disappeared or decreased in size on long-term follow-up CT scans. A conglomeration pattern (five patients) shrank and evolved into bronchial distortion. The shrinkage of the conglomeration pattern correlated with a decline of FEV1/FVC ratio, despite an improvement in FVC. A ground-glass opacity pattern (five patients) and a consolidation pattern (three patients) evolved into honeycombing. The evolution of the ground-glass opacity and consolidation patterns into honeycombing occurred along with a decline in FVC, although the parenchymal abnormalities became smaller.

Conclusion: Patients with a predominantly ground-glass opacity pattern and consolidation pattern seen on the initial CT scan had a worse prognosis and were susceptible to developing severe respiratory insufficiency. The predominant patterns seen on the initial HRCT scan may be helpful in predicting the outcomes of patients with sarcoidosis.

Key Words: high-resolution CT scan • pulmonary fibrosis • sarcoidosis




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