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Background <p>Connective tissue disease-associated interstitial lung disease (CTD-ILD) is an important factor leading to a poor prognosis in connective tissue disease (CTD) patients. To analyze the clinical and imaging data of CTD-ILD patients, summarize their characteristics, and explore the diagnostic value of certain specific High Resolution Computed Tomography (HRCT) manifestations and their distribution patterns for idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD).</p> Methods <p>This study conducted a retrospective analysis of demographic data and HRCT findings from 384 patients with CTD-ILD. Using multivariable logistic regression, hierarchical analysis, and sensitivity analysis to compare data from the IIM-ILD group and other connective tissue disease-associated interstitial lung disease (OCTD-ILD) group, we summarized the imaging features and distribution of IIM-ILD, providing imaging clues for its recognition.</p> Results <p>The distribution of different imaging features differed between the IIM-ILD patients and the OCTD-ILD patients. This study found that nonspecific interstitial pneumonia (NSIP) located in the upper lung field, as well as organized pneumonia (OP) located in the middle and lower lung fields, are relatively significant characteristics that distinguish idiopathic inflammatory myopathies (IIM) from other connective tissue disease (OCTD) (the odds ratios (OR) were 2.51, 5.46, and 8.33, respectively, <i>P</i> &lt; 0.001). If both NSIP in the upper lung field and OP in the lower lung field are present, diagnostic performance in differentiating IIM from OCTD will be further enhanced (sensitivity 55.90%, specificity 94.18%, accuracy 74.74%, OR 20.51, <i>P</i> &lt; 0.001).</p> Conclusions <p>This study indicated that for patients with CTD-ILD, specific HRCT manifestations could be used to distinguish IIM-ILD from OCTD-ILD, thereby assisting in clinical diagnosis. The coexistence of NSIP in the upper lung fields and OP in the lower lung fields would suggest a higher possibility of IIM-ILD.</p>

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Diagnostic significance of HRCT imaging features in idiopathic inflammatory myopathy-associated interstitial lung disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月29日

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  • Qian-yun Zhang,
  • Cai-Yu Li,
  • Chao-chao Wang,
  • Dong-dong Zhang,
  • Hong-yan Shao,
  • Ying Zhang

摘要

Background

Connective tissue disease-associated interstitial lung disease (CTD-ILD) is an important factor leading to a poor prognosis in connective tissue disease (CTD) patients. To analyze the clinical and imaging data of CTD-ILD patients, summarize their characteristics, and explore the diagnostic value of certain specific High Resolution Computed Tomography (HRCT) manifestations and their distribution patterns for idiopathic inflammatory myopathy-associated interstitial lung disease (IIM-ILD).

Methods

This study conducted a retrospective analysis of demographic data and HRCT findings from 384 patients with CTD-ILD. Using multivariable logistic regression, hierarchical analysis, and sensitivity analysis to compare data from the IIM-ILD group and other connective tissue disease-associated interstitial lung disease (OCTD-ILD) group, we summarized the imaging features and distribution of IIM-ILD, providing imaging clues for its recognition.

Results

The distribution of different imaging features differed between the IIM-ILD patients and the OCTD-ILD patients. This study found that nonspecific interstitial pneumonia (NSIP) located in the upper lung field, as well as organized pneumonia (OP) located in the middle and lower lung fields, are relatively significant characteristics that distinguish idiopathic inflammatory myopathies (IIM) from other connective tissue disease (OCTD) (the odds ratios (OR) were 2.51, 5.46, and 8.33, respectively, P < 0.001). If both NSIP in the upper lung field and OP in the lower lung field are present, diagnostic performance in differentiating IIM from OCTD will be further enhanced (sensitivity 55.90%, specificity 94.18%, accuracy 74.74%, OR 20.51, P < 0.001).

Conclusions

This study indicated that for patients with CTD-ILD, specific HRCT manifestations could be used to distinguish IIM-ILD from OCTD-ILD, thereby assisting in clinical diagnosis. The coexistence of NSIP in the upper lung fields and OP in the lower lung fields would suggest a higher possibility of IIM-ILD.