Abstract
Interstitial lung disease (ILD) is a hallmark of systemic sclerosis (SSc). Although high-resolution computed tomography (HRCT) is the gold standard to diagnose ILD, recently lung ultrasound (LUS) has emerged in SSc patients as a new promising technique for the ILD evaluation, noninvasive and radiation-free. The aim of this study was to evaluate if there is a correlation between LUS, chest HRCT, pulmonary function tests findings and clinical variables of the disease. Thirty-nine patients (33 women and 6 men; mean age 51 ± 15.2 years) underwent clinical examination, HRCT, pulmonary function tests and LUS for detection of B-lines. A positive correlation exists between the number of B-lines and the HRCT score (r = 0.81, p < 0.0001), conversely a negative correlation exists between the number of B-lines and diffusing capacity of the lung for carbon monoxide (DLCO) (r = −0.63, p < 0.0001). The number of B-lines increases along with the progression of the capillaroscopic damage. A statistically significant difference in the number of B-lines was found between patients with and without digital ulcers [42 (3–84) vs 16 (4–55)]. We found that the number of B-lines increased with the progression of both HRCT score and digital vascular damage. LUS may therefore, be a useful tool to determine the best timing for HRCT execution, thus, preventing for many patients a continuous and useless exposure to ionizing radiation.
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References
Shahin AA (2006) Pulmonary involvement in systemic sclerosis. Treat Respir Med 5:429–436
Pignone A, Matucci-Cerinic M, Lombardi A et al (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 11:465–472
Diot E, Boissinot E, Asquier E et al (1998) Relationship between abnormalities on high resolution CT and pulmonary function in systemic sclerosis. Chest 114:1623–1629
Porta F, Gargani L, Kaloudi O et al (2012) The new frontiers of ultrasound in the complex world of vasculitides and scleroderma. Rheumatology (Oxford) 51(7):26–30
van den Hoogen F, Khanna D, Fransen J et al (2013) Classification criteria for systemic sclerosis: an American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis Rheum 65:2737–2747
LeRoy EC, Black C, Fleischmajer R et al (1998) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 15:202–205
Volpicelli G, Elbarbary M, Blaivas M et al (2012) International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 38:577–591
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 93:1265–1270
Warrick JH, Bhalla M, Schabel SI et al (1991) High resolution computed tomography in early scleroderma lung disease. J Rheumatol 18:1520–1528
Miller MR, Crapo R, Hankinson J et al (2005) General considerations for lung function testing. Eur Respir J 26:153–161
Cutolo M, Sulli A, Pizzorni C, Accardo S (2000) Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol 27:155–160
Clements P, Lachenbruch P, Siebold J et al (1995) Inter- and intraobserver variability of the total thickness score (modified Rodnan TSS) in systemic sclerosis. J Rheumatol 22:1281–1285
Minier T, Nagy Z, Bálint Z et al (2010) Construct validity evaluation of the European Scleroderma Study Group activity index, and investigation of possible new disease activity markers in systemic sclerosis. Rheumatology (Oxford) 49:1133–1145
Medsger TA Jr, Silman AJ, Steen VD et al (1999) A disease severity scale for systemic sclerosis: development and testing. J Rheumatol 26:2159–2167
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
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(3):390–395
Sperandeo M, Varriale A, Sperandeo G et al (2009) Transthoracic ultrasound in the evaluation of pulmonary fibrosis: our experience. Ultrasound Med Biol 35(5):723–729
Matucci-Cerinic M, Kahaleh B, Wigley FM (2013) Systemic sclerosis (scleroderma, SSc) is a vascular disease. Arthritis Rheum 65:1953–1962
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The study has been approved by the ethics committee of Sapienza University according to the Declaration of Helsinki.
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Gigante, A., Rossi Fanelli, F., Lucci, S. et al. 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 (2016). https://doi.org/10.1007/s11739-015-1329-y
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DOI: https://doi.org/10.1007/s11739-015-1329-y