Advertisement

Clinical Rheumatology

, Volume 39, Issue 1, pp 119–123 | Cite as

The predictive role of lung ultrasound in progression of scleroderma interstitial lung disease

  • Maria Ludovica Gasperini
  • Antonietta Gigante
  • Andrea Iacolare
  • Chiara Pellicano
  • Silvio Lucci
  • Edoardo RosatoEmail author
Brief Report
Part of the following topical collections:
  1. Updates in Systemic Sclerosis

Abstract

Lung ultrasound (LUS) correlates with chest high-resolution computed tomography (HRCT) findings in the diagnosis of interstitial lung disease (ILD) in systemic sclerosis (SSc). The aim of this study is to evaluate the predictive value of LUS in the progression of ILD. At baseline, forty-one SSc patients underwent HRCT, LUS for detection of B-lines, and pulmonary function test (PFTs). PFTs were performed also after 12 months to evaluate pulmonary function deterioration. In multiple regression analysis, positive correlation exists between the number of B-lines and HRCT score (r = 0.51, p < 0.05), conversely a negative correlation exists between number of B-lines and carbon monoxide diffusing capacity (DLCO) (r = − 0.49, p < 0.05) and FVC (r = − 0.42, p < 0.05). The number of B-lines significantly (p < 0.05) increased with progression of digital microvascular damage. At 12 months, a positive correlation exists between number of B-lines and delta of DLCO. The ROC curves demonstrated a good accuracy of worsened DLCO prediction for Delta DLCO (0.72, p < 0.05 95% CI 0.56–0.88). The sum of B-lines correlates with the radiological score evaluated by HRCT. We also demonstrate that the number of B-lines can predict the worsening of the ILD. Although HRCT is the gold standard technique for assessing ILD, the LUS could become a useful tool for guiding the use of HRCT.

Key Points

• In systemic sclerosis patients, the number of B-lines can predict the worsening of the interstitial lung disease

• High-resolution computed tomography of chest is the gold standard technique for assessing interstitial lung disease

• Lung ultrasound could become a useful tool for guiding the use of high-resolution computed tomography of chest

Keywords

High-resolution CT Interstitial lung disease Lung ultrasound Pulmonary function tests Systemic sclerosis 

Notes

Compliance with ethical standards

Disclosures

None.

References

  1. 1.
    Molberg Ø, Hoffmann-Vold AM (2016) Interstitial lung disease in systemic sclerosis: progress in screening and early diagnosis. Curr Opin Rheumatol 28:613–618.  https://doi.org/10.1097/BOR.0000000000000323 CrossRefPubMedGoogle Scholar
  2. 2.
    Hoffmann-Vold AM, Aaløkken TM, Lund MB, Garen T, Midtvedt Ø, Brunborg C, Gran JT, Molberg Ø (2015) Predictive value of serial high-resolution computed tomography analyses and concurrent lung function tests in systemic sclerosis. Arthritis Rheum 67:2205–2212.  https://doi.org/10.1002/art.39166 CrossRefGoogle Scholar
  3. 3.
    Pignone A, Matucci-Cerinic M, Lombardi A, Fedi R, Fargnoli R, De Dominicis R, Cagnoni M (1992) High resolution computed tomography in systemic sclerosis. Real diagnostic utilities in the assessment of pulmonary involvement and comparison with other modalities of lung investigation. Clin Rheumatol 11:465–472CrossRefGoogle Scholar
  4. 4.
    Song G, Bae SC, Lee YH (2016) Diagnostic accuracy of lung ultrasound for interstitial lung disease in patients with connective tissue diseases: a meta-analysis. Clin Exp Rheumatol 34:11–16PubMedGoogle Scholar
  5. 5.
    Gigante A, Rossi Fanelli F, Lucci S, Barilaro G, Quarta S, Barbano B, Giovannetti A, Amoroso A, Rosato E (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 CrossRefPubMedGoogle Scholar
  6. 6.
    Van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A et al (2013) Classification criteria for systemic sclerosis: an American College of Rheumatology/European league against rheumatism collaborative initiative. Arthritis Rheum 65:2737–2747.  https://doi.org/10.1002/art.38098 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW et al (2012) International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591.  https://doi.org/10.1007/s00134-012-2513-4 CrossRefPubMedGoogle Scholar
  8. 8.
    Jam Jambrik Z, Monti S, Coppola V, Agricola E, Mottola G, Miniati M, Picano E (2004) Usefulness of ultrasound lung comets as a non radiologic sign of extravascular lung water. Am J Cardiol 93:1265–1270CrossRefGoogle Scholar
  9. 9.
    Gutierrez M, Salaffi F, Carotti M, Tardella M, Pineda C, Bertolazzi C, Bichisecchi E, Filippucci E, Grassi W (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 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Warrick JH, Bhalla M, Schabel SI, Silver RM (1991) High resolution computed tomography in early scleroderma lung disease. J Rheumatol 18:1520–1528PubMedGoogle Scholar
  11. 11.
    Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R et al (2005) ATS/ERS task force general considerations for lung function testing. Eur Respir J 26:153–161CrossRefGoogle Scholar
  12. 12.
    Cutolo M, Sulli A, Secchi ME, Paolino S, Pizzorni C (2006) Nailfold capillaroscopy is useful for the diagnosis and follow-up of autoimmune rheumatic diseases. A future tool for the analysis of microvascular heart involvement? Rheumatology 45:43–46CrossRefGoogle Scholar
  13. 13.
    Barskova T, Gargani L, Guiducci S, Randone SB, Bruni C, Carnesecchi G, Conforti ML, Porta F, Pignone A, Caramella D, Picano E, Cerinic MM (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 CrossRefPubMedGoogle Scholar
  14. 14.
    Montesi SB, Caravan P (2019) Novel imaging approaches in systemic sclerosis-associated interstitial lung disease. Curr Rheumatol Rep 21:25.  https://doi.org/10.1007/s11926-019-0826-9 CrossRefPubMedGoogle Scholar
  15. 15.
    Smith V, Decuman S, Sulli A, Bonroy C, Piettte Y, Deschepper E, de Keyser F, Cutolo M (2012) Do worsening scleroderma capillaroscopic patterns predict future severe organ involvement? A pilot study. Ann Rheum Dis 71:1636–1639.  https://doi.org/10.1136/annrheumdis-2011-200780 CrossRefPubMedGoogle Scholar
  16. 16.
    Hasegawa M, Asano Y, Endo H, Fujimoto M, Goto D, Ihn H, Inoue K, Ishikawa O, Kawaguchi Y, Kuwana M, Muro Y, Ogawa F, Sasaki T, Takahashi H, Tanaka S, Takehara K, Sato S (2012) Investigation of prognostic factors for skin sclerosis and lung function in Japanese patients with early systemic sclerosis: a multicentre prospective observational study. Rheumatology 51:129–133.  https://doi.org/10.1093/rheumatology/ker333 CrossRefPubMedGoogle Scholar

Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.Department of Translational and Precision MedicineSapienza University of RomeRomeItaly

Personalised recommendations