Chi Wang, Jun Hou, Jianming Lai, Ran Tao, Yang Yang, Wenhan Hao, Xinyu Yuan, Yuchun Yan
{"title":"CT评分与KL-6的相关性:评估青少年皮肌炎相关性肺间质性疾病的严重程度","authors":"Chi Wang, Jun Hou, Jianming Lai, Ran Tao, Yang Yang, Wenhan Hao, Xinyu Yuan, Yuchun Yan","doi":"10.1155/2023/5607473","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD.</p><p><strong>Aim: </strong>To establish a CT scoring system and calculate CT scores in JDM patients with ILD and to determine its reliability and the correlation with Krebs von den Lungen-6 (KL-6).</p><p><strong>Methods: </strong>The study totally enrolled 46 JDM-ILD patients and 16 JDM without ILD (non-ILD, NILD) patients. The chest CT images (7.0 ± 3.6 years; 32 male and 30 female) were all analyzed. CT scores of six lung zones were retrospectively calculated, included image pattern score and distribution range score. Image pattern score was defined as follows: increased broncho-vascular bundle (1 point); ground glass opacity (GGO) (2 points); consolidation (3 points); GGO with bronchiectasis (4 points); consolidation with bronchiectasis (5 points); and honeycomb lung (6 points). Distribution range score was defined as no infiltrate (0 point); <30% (1 point); 30%-60% (2 points); and ≥60% (3 points). Two pediatric radiologists reviewed all CT images independently. The ROC curve was established, and the optimal cutoff score for severity discrimination was set.</p><p><strong>Results: </strong>The agreement between two observers was excellent, and the ICC was 0.930 (95% CI 0.882-0.959, <i>p</i> < 0.01). CT score and KL-6 level had a positive linear correlation (<i>r</i> = 0.784, <i>p</i> < 0.01). However, the correlation between CT scores of different lung zone and KL-6 level was different. The KL-6 cut off level suggested for JDM with ILD was 209.0 U/ml, with 73.9% sensitivity and 87.5% specificity, and the area under curve was (AUC) 0.864 (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>The CT scoring system we established, as a semiquantitative method, can effectively evaluate ILD in JDM-PM patients and provide reliable evidence for treatment.</p>","PeriodicalId":9416,"journal":{"name":"Canadian respiratory journal","volume":"2023 ","pages":"5607473"},"PeriodicalIF":2.1000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10070020/pdf/","citationCount":"1","resultStr":"{\"title\":\"Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease.\",\"authors\":\"Chi Wang, Jun Hou, Jianming Lai, Ran Tao, Yang Yang, Wenhan Hao, Xinyu Yuan, Yuchun Yan\",\"doi\":\"10.1155/2023/5607473\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD.</p><p><strong>Aim: </strong>To establish a CT scoring system and calculate CT scores in JDM patients with ILD and to determine its reliability and the correlation with Krebs von den Lungen-6 (KL-6).</p><p><strong>Methods: </strong>The study totally enrolled 46 JDM-ILD patients and 16 JDM without ILD (non-ILD, NILD) patients. The chest CT images (7.0 ± 3.6 years; 32 male and 30 female) were all analyzed. CT scores of six lung zones were retrospectively calculated, included image pattern score and distribution range score. Image pattern score was defined as follows: increased broncho-vascular bundle (1 point); ground glass opacity (GGO) (2 points); consolidation (3 points); GGO with bronchiectasis (4 points); consolidation with bronchiectasis (5 points); and honeycomb lung (6 points). Distribution range score was defined as no infiltrate (0 point); <30% (1 point); 30%-60% (2 points); and ≥60% (3 points). Two pediatric radiologists reviewed all CT images independently. The ROC curve was established, and the optimal cutoff score for severity discrimination was set.</p><p><strong>Results: </strong>The agreement between two observers was excellent, and the ICC was 0.930 (95% CI 0.882-0.959, <i>p</i> < 0.01). CT score and KL-6 level had a positive linear correlation (<i>r</i> = 0.784, <i>p</i> < 0.01). However, the correlation between CT scores of different lung zone and KL-6 level was different. 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引用次数: 1
摘要
背景:目前还没有放射学测量来评估儿科青少年皮肌炎(JDM)合并间质性肺疾病(ILD)的严重程度。我们验证了CT评分评估在JDM合并ILD患者中的有效性。目的:建立JDM合并ILD患者的CT评分系统,计算CT评分,并确定其可靠性及与KL-6的相关性。方法:共入组46例JDM-ILD患者和16例JDM无ILD (non-ILD, NILD)患者。胸部CT影像(7.0±3.6岁);男性32例,女性30例)。回顾性计算6个肺区CT评分,包括图像模式评分和分布范围评分。图像模式评分定义如下:支气管-维管束增高(1分);毛玻璃不透明度(GGO)(2分);巩固(3分);GGO合并支气管扩张(4分);实变伴支气管扩张(5分);蜂窝肺(6分)。分布范围评分定义为无浸润(0分);结果:两名观察者之间的一致性极好,ICC为0.930 (95% CI 0.882-0.959, p < 0.01)。CT评分与KL-6水平呈线性正相关(r = 0.784, p < 0.01)。但不同肺带CT评分与KL-6水平的相关性存在差异。JDM合并ILD的KL-6临界值为209.0 U/ml,敏感性73.9%,特异性87.5%,曲线下面积(AUC)为0.864 (p < 0.01)。结论:我们建立的CT评分系统作为一种半定量的方法,可以有效地评价JDM-PM患者的ILD,为治疗提供可靠的依据。
Correlation between CT Score and KL-6: A Severity Assessing in Juvenile Dermatomyositis Associated Interstitial Lung Disease.
Background: There is no radiological measurement to estimate the severity of pediatrics juvenile dermatomyositis (JDM) with interstitial lung disease (ILD). We validated the effectiveness of CT scoring assessment in JDM patients with ILD.
Aim: To establish a CT scoring system and calculate CT scores in JDM patients with ILD and to determine its reliability and the correlation with Krebs von den Lungen-6 (KL-6).
Methods: The study totally enrolled 46 JDM-ILD patients and 16 JDM without ILD (non-ILD, NILD) patients. The chest CT images (7.0 ± 3.6 years; 32 male and 30 female) were all analyzed. CT scores of six lung zones were retrospectively calculated, included image pattern score and distribution range score. Image pattern score was defined as follows: increased broncho-vascular bundle (1 point); ground glass opacity (GGO) (2 points); consolidation (3 points); GGO with bronchiectasis (4 points); consolidation with bronchiectasis (5 points); and honeycomb lung (6 points). Distribution range score was defined as no infiltrate (0 point); <30% (1 point); 30%-60% (2 points); and ≥60% (3 points). Two pediatric radiologists reviewed all CT images independently. The ROC curve was established, and the optimal cutoff score for severity discrimination was set.
Results: The agreement between two observers was excellent, and the ICC was 0.930 (95% CI 0.882-0.959, p < 0.01). CT score and KL-6 level had a positive linear correlation (r = 0.784, p < 0.01). However, the correlation between CT scores of different lung zone and KL-6 level was different. The KL-6 cut off level suggested for JDM with ILD was 209.0 U/ml, with 73.9% sensitivity and 87.5% specificity, and the area under curve was (AUC) 0.864 (p < 0.01).
Conclusion: The CT scoring system we established, as a semiquantitative method, can effectively evaluate ILD in JDM-PM patients and provide reliable evidence for treatment.
期刊介绍:
Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.