Objective: To study the main computed tomography (CT) signs of primary pulmonary vasculitis at different stages of disease development.
Material and methods: Eighty-nine patients, including those with Wegener's granulomatosis (WG) (n = 60), Churg-Strauss syndrome (CSS) (n = 24), or microscopic polyangiitis (MPA) (n = 5), were examined. Vasculitis was diagnosed on the basis of comprehensive clinical, X-ray, and morphological examination. CT study was performed in 40 (85.1%) patients over time. Radiography encompassed chest X-ray and computed tomography.
Results: The CT signs of WG were as follows: parenchymal infiltrates in 41 (68.3%) patients, vast zones of ground glass and consolidation in 16 (21.6%), and bronchial wall thickening in 27 (46.7%). The infiltrates showed aseptic decay cavities in 26 (63.4%) cases. In CSS, the CT changes included ground glass symptom (100%), consolidation symptom (54.2%), bronchial wall thickening concurrent with bronchial dilatation (87.5%), and increased peripheral pulmonary vessel diameter (45.8%). CSS was typified by migratory infiltrates. The pulmonary manifestations of MPA were characterized by the regions of alveolar infiltration of varying intensity and extent.
Conclusion: The use of CT in pulmonary vasculitis makes it possible to reliably detect and differentiate pathological changes in the lung, to estimate their extent and monitor the efficiency of treatment.