Diagnosis and dynamic control of vascular disorders in patients with amiodarone-induced pulmonary toxicity (AIPT)

Abstract

Introduction. In the structure of interstitial lung diseases, drug­induced lung lesions occur in approximately 3 % of cases. One of the most pneumotoxic drugs used in cardiology is amiodarone. Its toxic effect is multicomponent and affects all structures of the bronchopulmonary system.Objective of the study was to estimate radiologic features and to follow up vascular disorders in the lungs in patients with amiodarone­induced pulmonary toxicity (AILT)Material and methods. We included 214 CT exams of 110 patients with history of amiodaron use. AILT was confrmed in 90 cases. In 81 % of patients we repeated CT exams 2–5 times, with observation period from 1 month up to 10 years. The mean age of patients was 71 years (21 females, 69 – males). In 52 % of patients lung scintigraphy was performed, in 34 % with follow up (from 2 to 4 times). We included functional lung test and cardiac ultrasound in diagnostic plan.Results. Three clinical and radiological forms of the disease were identifed: acute, subacute, and chronic. The acute form was observed in 3 % of cases, the subacute (in 68 %), the chronic form was determined during the frst examination (23 %) and during the transformation from the subacute form (38 %). According to SPECT­CT data 70 % of patients had pronounced diffuse microcirculation disorders, 30 % of patients developed perfusion disorders of moderate severity.Conclusion. There are persistent and irreversible changes in the lungs with AIPT in dynamic radiological examination, there is a tendency to fbrosis and recurrence and perfusion disorders in the lungs during treatment are not fully recovered. For suspected pulmonary embolism most informative diagnostic method is SPECT.