Chest CT Findings for IgG4-related Disease

Abstract

Abstract Objective To investigate the multi-slice spiral CT (MSCT) findings of chest involvement in IgG4-related diseases, and to improve doctors' understanding of this disease. Methods A retrospective analysis was carried out on the clinical and imaging data of 67 patients with clinically confirmed or suspected IgG4-related diseases. Results: A total of 60 patients (89.60%) had abnormal chest CT. Among them, 47 patients (70.10%) had enlarged mediastinal lymph nodes. Thickening of the tracheal and tracheobronchial perivascular wall was found in 35 cases (52.20%). Nodules were found in 29 cases (43.30%). There was patch or ground-glass density in 15 cases (22.40%), bilateral enlarged axillary lymph nodes in 9 cases (13.40%), bilateral enlarged hilar lymph nodes in 3 cases (4.50%) and interstitial changes in 8 cases (11.90%). Pleural effusion occurred in 5 cases (7.46%, 2 cases of bilateral and 3 cases of unilateral), and pericardial effusion in 3 cases (4.50%). Seven cases (10.45%) showed no obvious abnormality. The abnormally elevated IgG4 (>135mg/dL) was positively correlated with the thickening of the tracheal and tracheobronchial wall (r = 0.328, p = 0.007) and the enlargement of mediastinal lymph nodes (r = -0.252, p = 0.039); Logistic regression model 1 showed that the incidence of lung as the first symptom was increased in patients with bilateral enlarged hilar lymph node on chest images (OR = 16. 000, 95% CI: 1.280-200.010). Conclusion: The abnormal manifestations of chest lesions, especially lung involvement, on IgG4-RD were varied. Peribronchovascular involvement and lymph node enlargement are the most common manifestations. Chest CT examination is of great significance in the diagnosis and follow-up of IgG4-RLD.