Pulmonary function tests and CT scan in
the management of idiopathic pulmonary fibrosis.
Xaubet A, Agusti C, Luburich P, Roca J, Monton C, Ayuso MC, Barbera JA,
Rodriguez-Roisin R
Servei de Pneumologia i Al.lergia Respiratoria, Departament de Medicina,
Servei de Radiodiagnostic, Hospital Clinic, Universitat de Barcelona,
Barcelona, Spain.
Relationships between pulmonary function testing and high-resolution
computed tomography (HRCT) were studied in 39 untreated patients with
idiopathic pulmonary fibrosis (IPF) at diagnosis, 23 of whom were followed
during 7.5 +/- 0.3 mo (mean +/- SEM). At diagnosis, the extent of overall
lung involvement in the HRCT scans showed a moderate but significant
correlation only with FVC (r = -0.46, p = 0. 003) and DLCO (r = -0.40, p =
0.03). The extent of ground glass pattern also correlated with FVC (r =
-0.58, p = 0.0001). Arterial PO2 at peak exercise (n = 13 patients) showed a
significant association with the extent of both ground-glass pattern and
overall lung involvement in HRCT (r = -0.60, p = 0.02; and r = -0.64, p = 0.
01, respectively). On multivariate analysis a significant independent
correlation between the global disease extent in HRCT and both FVC and DLCO
was observed. Changes over time in the total extent of the disease evaluated
with HRCT scans were also related to those observed in DLCO and in FVC (r =
-0.57, p = 0.01, and r = -0. 51, p = 0.01, respectively). The present study
suggests that FVC and DLCO are the physiological variables that best reflect
the global extent of disease in IPF and thus may provide significant
information for the assessment of the disease's progression.