Recent studies have suggested that in patients with an idiopathic interstitial pneumonia (IIP), a probable usual interstitial pneumonia (UIP) pattern on chest computed tomography (CT) is sufficient to diagnose idiopathic pulmonary fibrosis (IPF) without histopathology. We retrospectively compared the prognosis and time to first acute exacerbation (AE) in IIP patients with a UIP and a probable UIP pattern on initial chest CT. One hundred and sixty IIP patients with a UIP pattern and 242 with a probable UIP pattern were identified. Probable UIP pattern was independently associated with longer survival time (adjusted hazard ratio 0.713, 95% CI 0.536–0.950; p=0.021) and time to first AE (adjusted hazard ratio 0.580, 95% CI 0.389–0.866; p=0.008). In subjects with a probable UIP pattern who underwent surgical lung biopsy, the probability of a histopathological UIP pattern was 83%. After multidisciplinary discussion and the inclusion of longitudinal behaviour, a diagnosis of IPF was made in 66% of cases. In IPF patients, survival time and time to first AE were not associated with CT pattern. Among subjects with a probable UIP pattern, compared to non-IPF patients, survival time and time to first AE were shorter in IPF patients. In conclusion, IIP patients with a probable UIP pattern on initial chest CT had a better prognosis and longer time to first AE than those with a UIP pattern. However, when baseline data and longitudinal behaviour provided a final diagnosis of IPF, CT pattern was not associated with these outcomes. This suggests diagnostic heterogeneity among patients with a probable UIP pattern. Except when the final diagnosis is IPF, idiopathic interstitial pneumonia (IIP) patients with a probable usual interstitial pneumonia (UIP) pattern on chest CT have a longer survival time and time to first acute exacerbation than those with a UIP pattern http://bit.ly/2FOJa2F

中文翻译：

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胸部 CT 上可能的 UIP 模式：是否足以诊断 IPF？

最近的研究表明，在特发性间质性肺炎 (IIP) 患者中，胸部计算机断层扫描 (CT) 上可能的普通间质性肺炎 (UIP) 模式足以在没有组织病理学的情况下诊断特发性肺纤维化 (IPF)。我们回顾性比较了初始胸部 CT 上有 UIP 和可能的 UIP 模式的 IIP 患者的预后和至首次急性加重 (AE) 的时间。确定了 160 名具有 UIP 模式的 IIP 患者和 242 名可能具有 UIP 模式的 IIP 患者。可能的 UIP 模式与更长的生存时间（调整后的风险比 0.713，95% CI 0.536–0.950；p=0.021）和至首次 AE 的时间（调整后的风险比 0.580，95% CI 0.389–0.866；p=0.00）独立相关。在接受外科肺活检的可能 UIP 模式的受试者中，组织病理学 UIP 模式的概率为 83%。经过多学科讨论并纳入纵向行为，66% 的病例被诊断为 IPF。在 IPF 患者中，生存时间和首次发生 AE 的时间与 CT 模式无关。在具有可能的 UIP 模式的受试者中，与非 IPF 患者相比，IPF 患者的生存时间和首次发生 AE 的时间更短。总之，在初始胸部 CT 中具有可能 UIP 模式的 IIP 患者比具有 UIP 模式的患者具有更好的预后和更长的首次 AE 时间。然而，当基线数据和纵向行为提供了 IPF 的最终诊断时，CT 模式与这些结果无关。这表明可能 UIP 模式的患者之间存在诊断异质性。除非最终诊断为 IPF，