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Title: Prevalence of Interstitial Lung Disease in Patients with Chronic Cough Taking Chest X-rays and CT Chest as Diagnostic Tools
Authors: Abdul Qadeer Khan, Shaista Nayyar, Sohaib Khalid, Irum Taqi, Murtaza Ahmed Khan
Journal: Journal of Islamabad Medical and Dental College (JIMDC)
Publisher: Healers Educational Society
Country: Pakistan
Year: 2024
Volume: 13
Issue: 1
Language: English
DOI: 10.35787/jimdc.v13i1.1073
Keywords: Computed tomographyChest x-rayInterstitial lung diseaseChronic Cough
Introduction: With well over 200 types of pulmonary disorders, ILD is a growing global health burden with chronic cough being the most frequent symptom. As it hampers the basic respiratory mechanism, it eventually deteriorates the overall quality of life. The diagnosis of ILD is quite challenging and the accuracy rates with conventional tests are quite low.
Material and methods: A cross-sectional study on 200 patients was performed in Sir Ganga Ram Hospital, Lahore, Pakistan. The study took place from the period of 15th April to 15th July 2023. Chest X-ray (CXR) and Computed Tomography (CT) Chest were used as diagnostic tools.
Results: The chest x-ray detected ILD in 114 (57%) while the chest CT identified in 178 (89%) of the patients. CXR and CT had a sensitivity of 65.05 and 95.65 and a specificity of 45.1 and 85.2 respectively. CXR and CT detected reticular opacity, nodular opacity, and ground glass opacity in 66% vs 81%, 41% vs 78%, and 33% vs 55% of the ILD patients. Dyspnoea (85%), fever (30%), arthralgia (24%), and weight loss (9%) were found as clinical indications.
Conclusion: CXR can be used to perform initial preliminary tests to filter out the presence of other diseases in patients with ILD. However, it cannot be solely relied on as a diagnostic tool. CT Chest can be the choice of imaging modality in diagnosing ILD as it outperformed CXR in many aspects of our study, with better precision, accuracy, sensitivity, and specificity.
To assess the prevalence of Interstitial Lung Disease (ILD) among patients with chronic cough and to compare the diagnostic accuracy of Chest X-ray (CXR) and Computed Tomography (CT) Chest.
A cross-sectional study was conducted on 200 patients at Pakistan Air Force Hospital, Islamabad, over a period of 6 months (April 15 to October 15, 2023). Patients were assessed using CXR and CT Chest. Inclusion criteria included ILD-suspected patients with chronic cough and specific imaging findings. Exclusion criteria included patients with ischemic heart disease, tuberculosis, chronic liver/kidney diseases, pregnant women, and individuals under 18 years. Data analysis involved calculating sensitivity and specificity, and correlations were made using chi-square tests.
graph TD;
A["Patient Recruitment 200 patients with chronic cough"] --> B["Perform Chest X-ray"];
B --> C["Assess for ILD on CXR"];
C -- Suspected ILD --> D["Perform CT Chest"];
D --> E["Assess for ILD on CT Chest"];
E --> F["Data Collection: Patient profiles, imaging results, symptoms"];
F --> G["Statistical Analysis: Sensitivity, Specificity, Chi-square tests"];
G --> H["Compare Diagnostic Accuracy of CXR and CT"];
H --> I["Formulate Conclusions and Recommendations"];
The study found that CT Chest significantly outperformed CXR in diagnosing ILD among patients with chronic cough, showing higher precision, accuracy, sensitivity, and specificity. The prevalence of ILD was higher in males (71%). The findings align with other studies that highlight the superior diagnostic capability of CT over CXR for ILD. While CXR can be used for initial screening, CT Chest is recommended as the primary imaging modality for diagnosing ILD.
CXR detected ILD in 57% of patients, while CT Chest identified it in 89%. CXR had a sensitivity of 65.05% and a specificity of 45.1%, whereas CT Chest had a sensitivity of 95.65% and a specificity of 85.2%. Reticular opacity was detected in 66% by CXR vs. 81% by CT; nodular opacity in 41% by CXR vs. 78% by CT; and ground glass opacity in 33% by CXR vs. 55% by CT. Dyspnoea (85%), fever (30%), arthralgia (24%), and weight loss (9%) were common clinical indications.
Interstitial Lung Disease is prevalent in patients with chronic cough, with a male predominance. CT Chest is the preferred imaging modality for diagnosing ILD due to its superior accuracy, sensitivity, and specificity compared to Chest X-ray. CXR can serve as a preliminary test but should not be relied upon solely for diagnosis.
1. Prevalence of ILD: Chest CT identified ILD in 178 out of 200 patients (89%).
2. Sensitivity of CT Chest: The study reported a sensitivity of 95.65% for CT Chest in diagnosing ILD.
3. Study Period: The study was conducted from April 15 to October 15, 2023.
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