Anti nötrofilik sitoplazmik antikor ilişkili vaskülitlerde aktif ve remisyon dönem toraks bilgisayarlı tomografi bulgularının karşılaştırilması: Retrospektif bir çalışma
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Dosyalar
Tarih
2016
Yazarlar
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Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Çalışmamızın amacı ANCA ilişkili vaskülitlerin aktif ve remisyon dönemlerinde elde olunan toraks BT tetkiklerindeki radyolojik bulgularm retrospektif olarak değerlendirilip farklılıkların ortaya konulması ve ANCA ilişkili vaskülit subgruplarının hastalığın klinik olarak aktif dönemlerindeki radyolojik bulgularının kıyaslanmasıdır. GEREÇ ve YÖNTEM: Çalışmamızda Nisan 2007 ve Nisan 2015 tarihleri arasında klinik,laboratuar veya histopatolojik olarak ANCA ilişkili vaskülit tanısı konan ve Ege Üniversitesi Tıp Fakültesi Hastanesi Romatoloji polikliniğinde takip edilen 92 hasta dahil edilmiştir.Bu 92 olgunun 57 tanesinin klinik olarak aktif dönemde,15 tanesinin remisyon döneminde ve 20 tanesinin de hem aktif hem remisyon dönemlerinde elde olunan PACS sisteminde kayıtlı toraks BT tetkikleri analiz edilerek hastalıkların aktif ve remisyon dönemlerindeki 15 radyolojik parametre kıyaslanmıştır. Aynca aktif dönemde aynı bulgular hastalık subgruplan arasında da kıyaslanmıştır. BULGULAR: Aktif dönem olgularda mediastinal lenfadenopati, konsolidasyonlar, buzlu cam yoğunluklan, plevral effüzyon ve kavitasyon bulgular' remisyon dönem olgulara göre belirgin yüksek saptanmıştır. Remisyon dönemde radyolojik olarak aktif dönem olgulara göre anlamlı yüksek saptanan radyolojik bulgu mevcut değildir. ANCA ilişkili vaskülit subgruplarımn aktif dönem radyolojik bulgularının kıyaslanmasında granülomatöz polianjitte; hem mikroskobik polianjit hem de eosonofilik granülomatoz polianjit olgularına göre kaviter lezyonlar anlamlı olarak yüksek izlendi. Ayrıca granülomatoz polianjit olgularında Churg-Strauss sendromu olgularına göre plevral effüzyon anlamlı yüksek saptandı. Mikroskopik polianjit olgularmda ise granülomatöz polianjite göre mozaik oligemi, interstisyel fibrozis ve kardiyomegali ;Churg-Strauss olgulannda ise mozaik oligemi ve peribronşial kalınlaşma granülomatoz polianjite göre anlamlı yüksek saptanmıştır. SONUÇ: ANCA ilişkili vaskülitler nadir görülen hastalıklar olup olguların aktif ve remisyon ayrımlannda, komplikasyonların tammlarımasında ve tedavi sonrası remisyon dönem takiplerinde Bilgisayarlı Tomografi etkin bir görüntüleme yöntemi olarak kullanılabilir.
PURPOSE The purpose of our study is to evaluate retrospectively radiological findings in thorax CT examiation which are obtained during active and remission periods of ANCA associated vasculitis and reveal differences and to compare radiological findings in clinically active periods of disease of ANCA associated vasculitis. MATERİALS AND METHODS 92 patients who are diagnosed with ANCA associated vasculitis clinically, laboratory or histopathologically between April 2007 and April 2015 and who were follewed up in Ege University Faculty of Medicine Hospital Rheumatology clinic were included our study. By analyzing thorax CT examination which are recorded in the PACS system which are obtained in 57 of these 92 patients clinically active period, 15 of them remission period and 20 of them both active and remission period. 15 radiological parameters in active and remission periods of diseases were compared. Furthermore the same findings were also compared among diseases subgroups in active period. FINDINGS Mediastinal lymphadenopathy, consolidations, ground glass opacities, pleural effusion and cavitation findings were found to be significantly higher in cases with active period than in cases with remission. In remission period finding which is statistically higher compared to active period cases was not observed. When active period radiological findings of ANCA associated vasculitis subgroups were compared cavitary lesions in granulomatous polyangiitis were observed to be significantly higher compared to both microscopic polyangiitis and Churg-Strauss syndrome .In addition in granulomatos polyangiitis cases pleural effusion was significantly higher than Churg-Strauss cases.In microscopic polyangiitis cases granulomatous polyangiitis compared to mosaic oligemia, interstitial fibrosis and cardiomegaly; in Churg-Strauss cases mosaic oligemia and peribroncial thickening compared to granulomatous polyangiitis were observed to be significantly higher. CONCLUSION ANCA associated vasculitis are rare disease and computerized tomography can be used as an effective imaging modality in active and remission divisions of warts,identification of complications and post-treatment remission period follow ups.
PURPOSE The purpose of our study is to evaluate retrospectively radiological findings in thorax CT examiation which are obtained during active and remission periods of ANCA associated vasculitis and reveal differences and to compare radiological findings in clinically active periods of disease of ANCA associated vasculitis. MATERİALS AND METHODS 92 patients who are diagnosed with ANCA associated vasculitis clinically, laboratory or histopathologically between April 2007 and April 2015 and who were follewed up in Ege University Faculty of Medicine Hospital Rheumatology clinic were included our study. By analyzing thorax CT examination which are recorded in the PACS system which are obtained in 57 of these 92 patients clinically active period, 15 of them remission period and 20 of them both active and remission period. 15 radiological parameters in active and remission periods of diseases were compared. Furthermore the same findings were also compared among diseases subgroups in active period. FINDINGS Mediastinal lymphadenopathy, consolidations, ground glass opacities, pleural effusion and cavitation findings were found to be significantly higher in cases with active period than in cases with remission. In remission period finding which is statistically higher compared to active period cases was not observed. When active period radiological findings of ANCA associated vasculitis subgroups were compared cavitary lesions in granulomatous polyangiitis were observed to be significantly higher compared to both microscopic polyangiitis and Churg-Strauss syndrome .In addition in granulomatos polyangiitis cases pleural effusion was significantly higher than Churg-Strauss cases.In microscopic polyangiitis cases granulomatous polyangiitis compared to mosaic oligemia, interstitial fibrosis and cardiomegaly; in Churg-Strauss cases mosaic oligemia and peribroncial thickening compared to granulomatous polyangiitis were observed to be significantly higher. CONCLUSION ANCA associated vasculitis are rare disease and computerized tomography can be used as an effective imaging modality in active and remission divisions of warts,identification of complications and post-treatment remission period follow ups.
Açıklama
Anahtar Kelimeler
ANCA İlişkili Vaskülitler, Aktif Ve Remisyon Dönem, Toraks BT Bulguları, ANCA Associated Vasculitis, Active And Remission Period, Thorax CT Findings
