RADIATION AND MORPHOLOGICAL DIAGNOSIS OF ACUTE INTERSTITIAL PNEUMONIA BEFORE THE COVID-19 PANDEMIC

Abstract

Purpose of the study. To evaluate the radiation and morphological patterns of acute interstitial pneumonia (AIP) in different nosological forms, their differential diagnostic criteria, to develop an optimal algorithm for assessing radiation changes. Materials and methods. From 2006 to 2020 at the St. Petersburg State Medical University named after. acad. I.P. Pavlov, 173 patients with clinical and radiological picture of AIP were observed, all of them had an acute course of the disease with the presence of shortness of breath (up to shortness of breath at rest), fever, increased acute phase parameters and radiation signs of alveolitis or bronchiolitis. The average age of the patients was 38.3±5.2 years (w/m - 98/75). All patients underwent traditional X-ray studies (radiography in two projections), high resolution computed tomography (HRCT), if possible, a comprehensive functional study of external respiration (CFID) and echocardiography. Results. Analysis of the results of radiological and morphological studies revealed patterns of different nosological forms of AIP: 1) The primary idiopathic form of AIP (Hamman-Rich disease) was detected in 2 patients; 2) AIP during exacerbation of of idiopathic pulmonary fibrosis (IPF) (detected in 7 patients); 3) AIP in toxic alveolitis with a known agent (amiodarone lung in 2 patients); 4) AIP in acute course of diffuse connective tissue diseases (systemic lupus erythematosus cross syndrome) in 4 patients; 5) AIP during infectious processes was determined in 158 patients: in 27 patients with pneumocystis pneumonia, in 49 patients with viral pneumonia (including 10 with the development of acute respiratory distress syndrome), in 82 patients with exudative bronchiolitis and bronchopneumonia. Findings. The accumulation of experience in the clinical and radiological examination of patients with AIP and their comparison with morphological data made it possible to develop a radiological algorithm that is important for determining treatment tactics.