Ultrasound in the interstitial pulmonary fibrosis. Can it facilitate a best routine assessment in rheumatic disorders?

Gutiérrez, Marwin; Gómez–Quiroz, Luis E.; Clavijo-Cornejo, Denise; Lozada, Carlos; Lozada-Navarro, A C; Labra, Roxana Uri Miranda; Fernández‐Torres, Javier; Sánchez-Bringas, Guadalupe; Salaffi, Fausto; Bertolazzi, Chiara; Pineda, Carlos

doi:10.1007/s10067-016-3329-3

Cited by 5 publications

(3 citation statements)

References 33 publications

(37 reference statements)

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“…During the last years, a growing interest on the role of LUS in the detection of SSc-ILD raised. [10–14,21–24] However, up to now, the right placement of LUS in the diagnostic or follow-up route of SSc-ILD patients has not been clarified. In this work, a cut-off point for LUS was defined: if 10 B-lines are detectable, there is a high probability to face a SSc-ILD deserving a HRCT scan.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis

et al. 2018

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The aim of this study was to establish the cut-off point of ultrasound (US) B-lines number for detecting the presence of significant interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) (SSc-ILD) in relation to high-resolution computed tomography (HRCT) findings. Consecutive SSc-ILD patients underwent chest HRCT, lung US (LUS), pulmonary function test, and clinical assessment. Exclusion criteria were represented by the presence of a coexisting congestive heart failure and a clinical history suggestive of lung or pleural diseases. HRCT images were scored for the presence of ILD by 2 readers, in accordance with the Warrick scoring system. US assessment was performed by a US skilled rheumatologist, blinded to HRCT results and clinical data, and included the bilateral evaluation of 14 lung intercostal spaces (LIS). In each LIS, the number of B-lines was recorded and summed. To test discriminant validity, we used the receiver operating characteristic (ROC) curve analysis applying a Warrick score of 7 as external criterion for the presence of SSc-ILD. Forty patients completed the study. The US B-lines number and the Warrick score confirmed excellent correlation (Spearman rho: 0.958, P = .0001). The ROC curve analysis revealed that the presence of 10 US B-lines is the cut-off point with the greatest positive likelihood ratio (12.52) for the presence of significant SSc-ILD. The detection of 10 B-lines is highly predictive for the HRCT presence of significant SSc-ILD. In SSc patients, the LUS assessment as first imaging tool may represent an effective model to improve the correct timing of chest HRCT.

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Section: Discussionmentioning

confidence: 99%

Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis

et al. 2018

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“…Given the high sensitivity of lung ultrasound regarding changes in the peripheral lung, its capacity to detect interstitial lung disease related to pulmonary fibrosis is not surprising [51]. Interstitial fibrosis with thickened interlobular and intralobular septa results in an inhomogeneous, diffuse B-line pattern.…”

Section: Pulmonary Fibrosismentioning

confidence: 99%

Ultrasonography of the Lung

Radziņa

Biederer

2019

Fortschr Röntgenstr

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ABSTR AC T Background High diagnostic accuracy, increasing clinical experience and technical improvements are good reasons to consider lung ultrasound (US) for the assessment of pleural and pulmonary diseases. In the emergency room and in intensive care, it is well acknowledged, but application in other settings is rare. The aim of this review is to update potential users in general radiology about the diagnostic scope of lung US and to encourage more frequent use of this generally underestimated lung imaging modality.Method Literature review was done independently by the two authors in MEDLINE (via PubMed) covering a time span from 2002 until 2017 using free text and Medical Subject Headings/MeSH. Article selection for the bibliography was based on consensus according to relevance and evidence. Results and ConclusionThe technical prerequisites include a standard ultrasound unit with a suitable transducer. Pleural effusion and pneumothorax, atelectasis, interstitial edema, pneumonia, exacerbated chronic obstructive pulmonary disease/asthma and pulmonary embolism can be distinguished by particular ultrasound signs, artifacts and their combinations. A highly standardized selection of access points and terminology for the description of imaging findings contributes to high diagnostic accuracy even in challenging patients and settings. Besides the assessment of acute respiratory failure in the emergency room, lung US may be used for monitoring interstitial fluid accumulation in volume therapy and for the diagnosis of pneumonia or the assessment of pleural effusion and pleurisy in a routine outpatient setting. Last but not least, the increasing concerns about medical radiation exposure warrant a more extensive use of this sometimes underestimated modality as a cost-, time-and radiation-saving alternative or valuable adjunct to the standard imaging modalities. Key Points:▪ Lung US is a safe, quick and readily available method with options for dynamic imaging of respiratory function. ▪ Proper selection of technical parameters customized to the clinical question and standardized terminology for the precise description and interpretation of the imaging signs regarding patient history determine its diagnostic accuracy. ▪ In dyspnea lung US differentiates pneumothorax, lung edema, pneumonia, pulmonary embolism, atelectasis and pleural effusion. ▪ In intensive care, lung US allows monitoring of lung ventilation and fluid administration. ▪ It saves radiation exposure in serial follow-up, in pregnancy and pediatric radiology. Citation Format ▪ Radzina M, Biederer J, Ultrasonography of the Lung. Fortschr Röntgenstr 2019; 191: 909-923

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“…IPF is a frequent manifestation in patients with CTD [27][28][29][30]. Recently, the US criterion validity for its assessment has been proposed [27,28]. In their article, "Ultrasound as a potential tool for the assessment of interstitial lung disease in rheumatic patients.…”

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confidence: 99%

Musculoskeletal imaging of the inflammatory and degenerative joints: current status and perspectives

2019

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Ultrasound in the interstitial pulmonary fibrosis. Can it facilitate a best routine assessment in rheumatic disorders?

Cited by 5 publications

References 33 publications

Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis

Ultrasound B-lines in the evaluation of interstitial lung disease in patients with systemic sclerosis

Ultrasonography of the Lung

Musculoskeletal imaging of the inflammatory and degenerative joints: current status and perspectives

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