{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T10:25:50Z","timestamp":1756895150585,"version":"3.37.3"},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Radiol Imaging"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Purpose\u2003Usual interstitial pneumonia (UIP) pattern of interstitial lung disease (ILD) can have varied etiology, with connective tissue disease (CTD) being a common known cause. The anterior upper lobe (AUL) sign, exuberant honeycombing (EHC), and straight edge (SE) sign are recently described computed tomography (CT) signs in CTD-related UIP. We test the diagnostic value of these CT signs for CTD in patients with UIP and compare the incidence of these signs between CTD-related UIP and non\u2013CTD-related UIP. We also evaluated the interobserver agreement in detection of these CT signs.<\/jats:p><jats:p>\n          Methods\u2003Retrospective study of all patients who had UIP pattern of ILD on CT thorax done from January 1, 2016 to January 31, 2019, was grouped into two: non\u2013CTD-related UIP or CTD-related UIP. CT thorax was reviewed for the presence of these signs\u2014AUL, SE, and EHC. The diagnostic values of these signs in diagnosing CTD-related UIP was assessed. For assessment of interobserver agreement, another radiologist reviewed a subset of 30 randomly selected cases and looked for the presence of these signs.<\/jats:p><jats:p>\n          Results\u2003Of the 156 patients included, 76 had CTD. The incidence of CT signs were significantly higher in CTD-related UIP. The specificities of AUL, EHC, and SE were 82.5, 75, and 85%, respectively. The EHC sign had highest sensitivity of 48.7%. Inclusion of more than one sign increased the specificity of diagnosis of CTD-related UIP; however, the sensitivity decreases. There was excellent interobserver agreement (0.81\u20130.87) for each of these signs.<\/jats:p><jats:p>\n          Conclusion\u2003The presence of SE, AUL, and EHC signs in cases with UIP pattern are specific imaging markers to diagnose underlying CTD; however, due to its low sensitivity, the absence of these signs cannot exclude the same. Because of its excellent interobserver agreement, these signs are reliable in the evaluation of CTD-related ILD.<\/jats:p>","DOI":"10.1055\/s-0042-1758876","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T23:44:16Z","timestamp":1672098256000},"page":"070-075","source":"Crossref","is-referenced-by-count":2,"title":["Diagnostic Value of Connective Tissue Disease Related CT Signs in Usual Interstitial Pneumonia Pattern of Interstitial Lung Disease"],"prefix":"10.1055","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3694-9387","authenticated-orcid":false,"given":"Antony","family":"Augustine","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6339-4567","authenticated-orcid":false,"given":"Leena","family":"Robinson Vimala","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparna","family":"Irodi","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mini","family":"Pakkal","sequence":"additional","affiliation":[{"name":"Joint Department of Medical Imaging, Toronto General Hospital, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"issue":"133","key":"ref1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1183\/09059180.00004914","article-title":"Differential diagnosis of usual interstitial pneumonia: when is it truly idiopathic?","volume":"23","author":"W A Wuyts","year":"2014","journal-title":"Eur Respir Rev"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1164\/rccm.201807-1255ST","article-title":"Diagnosis of idiopathic pulmonary fibrosis. an official ATS\/ERS\/JRS\/ALAT clinical practice guideline","volume":"198","author":"G Raghu","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/RTI.0b013e3181c1acec","article-title":"Lung disease related to collagen vascular disease","volume":"24","author":"D A Lynch","year":"2009","journal-title":"J Thorac Imaging"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e94775","DOI":"10.1371\/journal.pone.0094775","article-title":"Usual interstitial pneumonia preceding collagen vascular disease: a retrospective case control study of patients initially diagnosed with idiopathic pulmonary fibrosis","volume":"9","author":"M Kono","year":"2014","journal-title":"PLoS One"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1183\/09031936.00094910","article-title":"Idiopathic nonspecific interstitial pneumonia: an interstitial lung disease associated with autoimmune disorders?","volume":"38","author":"M Romagnoli","year":"2011","journal-title":"Eur Respir J"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s00296-005-0028-9","article-title":"Non-specific interstitial pneumonia; 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Results of a prospective registry","volume":"195","author":"S Singh","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1183\/09031936.00174910","article-title":"Significance of connective tissue disease features in idiopathic interstitial pneumonia","volume":"39","author":"T J Corte","year":"2012","journal-title":"Eur Respir J"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1148\/rg.291085096","article-title":"Nonspecific interstitial pneumonia: radiologic, clinical, and pathologic considerations","volume":"29","author":"S J Kligerman","year":"2009","journal-title":"Radiographics"}],"container-title":["Indian Journal of Radiology and Imaging"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1758876.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T23:48:19Z","timestamp":1677455299000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1758876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,26]]},"references-count":19,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2023,2,26]]},"published-print":{"date-parts":[[2023,1]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1758876","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0971-3026","1998-3808"],"issn-type":[{"type":"print","value":"0971-3026"},{"type":"electronic","value":"1998-3808"}],"subject":[],"published":{"date-parts":[[2022,12,26]]}}}