Abstract
Lung ultrasound (LUS) achieved an intriguing role in the management of pulmonary involvement in patients affected by connective tissues diseases (CTDs). Few studies have been performed to support its usefulness in the evaluation of the presence and the severity of interstitial lung disease (ILD), relating it to the information obtained with chest high-resolution computed tomography (HRCT). These results open up new fields of research in order to demonstrate the utility of LUS as screening tool to evaluate ILD in CTD. The aim of this review is to provide the “state of the art” of the role of LUS in the management of ILD associated with CTD.
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References
Cappelli S, Bellando Randone S, Camiciottoli G et al (2015) Interstitial lung disease in systemic sclerosis: where do we stand? Eur Respir Rev 24:411–419. https://doi.org/10.1183/16000617.00002915
Adler S, Huscher D, Siegert E et al (2018) Systemic sclerosis associated interstitial lung disease—individualized immunosuppressive therapy and course of lung function: results of the EUSTAR group. Arthritis Res Ther 20:17. https://doi.org/10.1186/s13075-018-1517-z
Salaffi F, Carotti M, Baldelli S et al (1999) Subclinical interstitial lung involvement in rheumatic diseases. Correlation of high resolution computerized tomography and functional and cytologic findings. Radiol Med 97:33–41
Manganelli P, Salaffi F, Pesci A (1997) Clinical and subclinical alveolitis in connective tissue diseases assessed by bronchoalveolar lavage. Semin Arthritis Rheum 26:740–754
Lichtenstein DA, Mezière GA (2008) Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 134:117–125. https://doi.org/10.1378/chest.07-2800
Lichtenstein D, Hulot JS, Rabiller A et al (1999) Feasibility and safety of ultrasound-aided thoracentesis in mechanically ventilated patients. Intensive Care Med 25:955–958
Lichtenstein D, Mezière G, Biderman P, Gepner A (1999) The comet-tail artifact: an ultrasound sign ruling out pneumothorax. Intensive Care Med 25:383–388
Frassi F, Gargani L, Gligorova S et al (2007) Clinical and echocardiographic determinants of ultrasound lung comets. Eur J Echocardiogr 8:474–479. https://doi.org/10.1016/j.euje.2006.09.004
Agricola E, Bove T, Oppizzi M et al (2005) “Ultrasound comet-tail images”: a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest 127:1690–1695. https://doi.org/10.1378/chest.127.5.1690
Picano E, Gargani L, Gheorghiade M (2010) Why, when, and how to assess pulmonary congestion in heart failure: pathophysiological, clinical, and methodological implications. Heart Fail Rev 15:63–72. https://doi.org/10.1007/s10741-009-9148-8
Sperandeo M, Varriale A, Sperandeo G et al (2009) Transthoracic ultrasound in the evaluation of pulmonary fibrosis: our experience. Ultrasound Med Biol 35:723–772. https://doi.org/10.1016/j.ultrasmedbio.2008.10.009
Copetti R, Soldati G, Copetti P (2008) Chest sonography: a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound 6:16. https://doi.org/10.1186/1476-7120-6-16
Gargani L, Doveri M, D’Errico L et al (2009) Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis. Rheumatology (Oxford) 48:1382–1387. https://doi.org/10.1093/rheumatology/kep263
Moazedi-Fuerst FC, Kielhauser S, Brickmann K et al (2015) Sonographic assessment of interstitial lung disease in patients with rheumatoid arthritis, systemic sclerosis and systemic lupus erythematosus. Clin Exp Rheumatol 33:S87–S91
Sperandeo M, De Cata A, Molinaro F et al (2015) Ultrasound signs of pulmonary fibrosis in systemic sclerosis as timely indicators for chest computed tomography. Scand J Rheumatol 44:389–398. https://doi.org/10.3109/03009742.2015.1011228
Tardella M, Gutierrez M, Salaffi F et al (2012) Ultrasound in the assessment of pulmonary fibrosis in connective tissue disorders: correlation with high-resolution computed tomography. J Rheumatol 39:1641–1647. https://doi.org/10.3899/jrheum.120104
Gutierrez M, Salaffi F, Carotti M et al (2011) Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders–preliminary results. Arthritis Res Ther 13:R134. https://doi.org/10.1186/ar3446
Jambrik Z, Monti S, Coppola V et al (2004) Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water. Am J Cardiol 93(10):1265–1270
Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097
Wells GA, Shea B, O’Connell D et al (2005) Ottawa Hospital Research Institute. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. Accessed 2 Oct 2005
Warrick JH, Bhalla M, Schabel SI et al (1991) High resolution computed tomography in early scleroderma lung disease. J Rheumatol 18:1520–1528
Delle Sedie A, Doveri M, Frassi F et al (2010) Ultrasound lung comets in systemic sclerosis: a useful tool to detect lung interstitial fibrosis. Clin Exp Rheumatol 28:S54
Moazedi-Fuerst FC, Zechner PM, Tripolt NJ et al (2012) Pulmonary echography in systemic sclerosis. Clin Rheumatol 31:1621–1625. https://doi.org/10.1007/s10067-012-2055-8
Barskova T, Gargani L, Guiducci S et al (2013) Lung ultrasound for the screening of interstitial lung disease in very early systemic sclerosis. Ann Rheum Dis 72:390–395. https://doi.org/10.1136/annrheumdis-2011-201072
Mohammadi A, Oshnoei S, Ghasemi-rad M (2014) Comparison of a new, modified lung ultrasonography technique with high-resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma. Med Ultrason 16:27–31
Buda N, Piskunowicz M, Porzezińska M et al (2016) Lung ultrasonography in the evaluation of interstitial lung disease in systemic connective tissue diseases: criteria and severity of pulmonary fibrosis—analysis of 52 patients. Ultraschall Med 37:379–385. https://doi.org/10.1055/s-0041-110590
Gigante A, Rossi Fanelli F, Lucci S et al (2016) Lung ultrasound in systemic sclerosis: correlation with high-resolution computed tomography, pulmonary function tests and clinical variables of disease. Intern Emerg Med 11:213–217. https://doi.org/10.1007/s11739-015-1329-y
Çakir Edis E, Hatipoğlu ON, Pamuk ÖN et al (2016) Effectiveness of thoracic ultrasonography in the evaluation of the severity of pulmonary involvement in patients with systemic sclerosis. Arch Rheumatol 31:364–370. https://doi.org/10.5606/ArchRheumatol.2016.5849
Tardella M, Di Carlo M, Carotti M et al (2018) Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis: cut-off point definition for the presence of significant pulmonary fibrosis. Medicine (Baltimore) 97:e0566. https://doi.org/10.1097/MD.0000000000010566
Hassan RI, Lubertino LI, Barth MA et al (2018) Lung ultrasound as a screening method for interstitial lung disease in patients with systemic sclerosis. J Clin Rheumatol. https://doi.org/10.1097/RHU.0000000000000860
Aghdashi M, Broofeh B, Mohammadi A (2013) Diagnostic performances of high resolution trans-thoracic lung ultrasonography in pulmonary alveoli-interstitial involvement of rheumatoid lung disease. Int J Clin Exp Med 6:562–566
Cogliati C, Antivalle M, Torzillo D et al (2014) Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients. Rheumatology (Oxford) 53:1497–1503. https://doi.org/10.1093/rheumatology/keu033
Hasan AA, Makhlouf HA (2014) B-lines: transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases. Ann Thorac Med 9:99–103. https://doi.org/10.4103/1817-1737.128856
Moazedi-Fuerst FC, Kielhauser SM, Scheidl S et al (2014) Ultrasound screening for interstitial lung disease in rheumatoid arthritis. Clin Exp Rheumatol 32:199–203
Pinal-Fernandex I, Pallisa Nuñez E, Selva-O’Callaghan A et al (2015) Pleural irregularity, a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome. Clin Exp Rheumatol 33:S136–S141
Vasco PG, de Luna Cardenal G, Garrido IM et al (2017) Assessment of interstitial lung disease in Sjögren’s syndrome by lung ultrasound: a pilot study of correlation with high-resolution chest tomography. Intern Emerg Med 12:327–331. https://doi.org/10.1007/s11739-016-1582-8
Salaffi F, Manganelli P, Carotti M, Baldelli S (2000) The differing patterns of subclinical pulmonary involvement in connective tissue diseases as shown by application of factor analysis. Clin Rheumatol 19:35–41
Wells AU, Rubens MB, du Bois RM, Hansell DM (1997) Functional impairment in fibrosing alveolitis: relationship to reversible disease on thin section computed tomography. Eur Respir J 10:280–285
Latsi PI, Wells AU (2003) Evaluation and management of alveolitis and interstitial lung disease in scleroderma. Curr Opin Rheumatol 15:748–755
Salaffi F, Carotti M, Baldelli S et al (1999) Subclinical interstitial lung involvement in rheumatic diseases. Correlation of high resolution computerized tomography and functional and cytologic findings. Radiol Med 97:33–41
Soldati G (2006) Sonographic findings in pulmonary diseases. Radiol Med 111:507–515. https://doi.org/10.1007/s11547-006-0046-z
Gutiérrez J, Gutierrez M, Almaguer K et al (2018) OP0141 Ultrasound diagnostic and predictive value of interstitial lung disease in systemic sclerosis.diagnostic and predictive value of ultrasound in the assessment of interstitial lung disease. Ann Rheum Dis 77:121. https://doi.org/10.1136/annrheumdis-2018-eular.6790
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The authors would like to make the following statements with regard to their conflicts of interest/financial disclosures: MG has attended advisory board meetings and scientific consultancies and has obtained speaking fees for: AbbVie, Novartis, UCB, Esaote SpA, Janssen, Bristol-Myers Squibb, Merck Sharp & Dohme, Pfizer, Sanofi Aventis. MT, LR, JM, DC-C, AG, CB declare that they have no competing interests.
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Gutierrez, M., Tardella, M., Rodriguez, L. et al. Ultrasound as a potential tool for the assessment of interstitial lung disease in rheumatic patients. Where are we now?. Radiol med 124, 989–999 (2019). https://doi.org/10.1007/s11547-019-01053-5
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DOI: https://doi.org/10.1007/s11547-019-01053-5