Murat BAYKARA, Nursel YURTTUTAN, Nurhan ATİLLA, Betül ŞEREFLİCAN, Betül KIZILDAĞ, Gözde YILDIRIM ÇETİN, Mehmet Akif SARICA

Behçet hastalığında görülen toraks bilgisayarlı tomografi bulgularını kavrama

Giriş: Bu çalışmada Behçet hastalığı (BH)'nda göğüs çok kesitli bilgisayarlı tomografi (ÇKBT)’de görülen anormal bulguların sıklığını ve spektrumunu değerlendirmeyi amaçladık. Materyal ve Metod: Çalışmaya 2009-2016 yılları arasında, daha önce ya da ilk olarak BH tanısı konulan ve radyoloji bölümüne toraks ÇKBT çekilmek üzere gönderilen toplam 44 hasta retrospektif oarak değerlendirildi. Pulmoner arter, diğer büyük damarlar, kalp, mediasten, plevra ve perkikarddaki anormal bulgular not edildi. Bulgular: On altı hastada bir ya da birden fazla BH ile ilişkili anormal bulgu vardı. Pulmoner arter tutulumu 12 hasta ile en sık (%27.2) ortaya çıkış şekli olup 8 tanesinde tromboz 4 tanesinde anevrizma vardı. Ortalama pulmoner arter çapı 29 ± 3.7 mm idi. Pulmoner arter tutulumu olan hastaların pulmoner arter çapları olmayanlara göre anlamlı olarak daha fazlaydı (p< 0.001). Hilus çevresinde kıvrımlı vasküler yapı olarak görülen hipertrofik bronşiyal arter en sık görülen bilgisayarlı tomografi (BT) bulgusuydu (%66.6). Akciğer parankim bulguları subplevral alveolar opasiteler, fokal atelektazi ve iyi sınırlı olmayan nodüler opasiteler şeklindeydi ve bunlar nadiren izole olup genellikle pulmoner arter tutulumu ile birliktelik gösteriyordu. Kalpte dolum defekti pulmoner arter anevrizması olan hastalarda en sık eşlik eden lezyonlardı (%75). Sonuç: BH'nin toraks BT bulguları ayrık anatomik bölgelerin aynı anda tutulumunun olabileceği geniş bir lezyon spektrumu ile ilişkilidir. Pulmoner arterde genişleme ve genişlemiş bronşiyal arter pulmoner arter tutulumu için önemli ipuçlarıdır. Kalp boşlukları özelikle pulmoner arter tutulumu olan hastalarda dolum defektleri açısından gözden geçirilmelidir.

Insights into chest computed tomography findings in Behcet’s disease

Introduction: To evaluate the spectrum and frequency of abnormal chest multidedector computed tomography (MDCT) findings inBehcet’s disease(BD).Materials and Methods: Chest MDCT scans of 44 patients referred to radiology department for chest symptoms those had prior ornewly established diagnosis of BD between 2009-2016 were retrospectively reviewed. Abnormal findings within pulmonary artery(PA), lungs, other large vessels, heart, mediastinum, pleura and pericardium were noted.Results: Sixteen patients had one ore more computed tomography (CT) findings related to BD. PA involvement was most common(27.2%) presentation revealing thrombosis in 8 and aneurysms in 4 of 12 patients. Mean PA diameter was 29 ± 3.7 mm. Patientswith PA involvement had significantly higher PA diameters than those without (p< 0.001). Hypertrophied bronchial artery seen asserpiginous vessels around hilum was a common finding (66.6%). Lung parenchyma findings was rarely isolated and usuallyassociated with PA involvement with subpleural alveolar opacities, focal atelectasis and ill-defined nodular opacities. Cardiac fillingdefects were accompanying lesions in most of patients with PA aneurysms (75%).Conclusion: BD is associated with a wide spectrum of simultaneous involvement of discrete anatomical sites. PA enlargement andhypertrophied bronchial artery is a clue for patients with PAinvolvement. Heart chambers should be checked for filling defectsparticularly in patients with PA aneurysms.

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