Objectives. Interstitial lung disease (ILD) is a frequent extra-articular manifestation of RA associated with increased mortality. High-resolution CT (HRCT) is used for diagnosis and follow-up, but its accuracy is counterbalanced by high costs and radiological risk. In the presence of ILD, lung US (LUS) detects vertical artefacts called B-lines. The aims of the present study were to evaluate the accuracy of LUS in the diagnosis of ILD in RA and to validate the use of a pocket-size US device (PS-USD) as a screening tool.Methods. LUS was performed with standard equipment by a trained physician through longitudinal scans following anatomical lines: 72 segments were considered (28 anteriorly and 44 posteriorly) and B-lines were counted in each segment. A B-lines score >10 identified a positive examination (presence of ILD). A second LUS session for positive/negative judgment was performed by a short-trained physician using a PS-USD.Results. Thirty-nine patients were studied. The sensitivity and specificity of standard LUS vs HRCT were 92% and 56%, respectively. The B-line score was significantly correlated with HRCT score (r = 0.806). A total of 29 patients were studied with a PS-USD. Sensitivity and specificity for PS-USD vs HRCT were 89% and 50%.Conclusion. The sensitivity of LUS in the detection of ILD supports its use as a screening test for ILD in RA patients, even in the ambulatory setting with a PS-USD. The strong correlation between echographic and HRCT scores indicates LUS is a valid tool for grading and follow-up of ILD.
Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients / C. Cogliati, M. Antivalle, D. Torzillo, S. Birocchi, A. Norsa, R. Bianco, G. Costantino, M.C. Ditto, M. Battellino, P.C. Sarzi Puttini, N. Montano. - In: RHEUMATOLOGY. - ISSN 1462-0324. - 53:8(2014 Aug), pp. 1497-1503.
|Titolo:||Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients|
MONTANO, NICOLA (Ultimo)
|Parole Chiave:||B-lines; Interstitial lung disease; Lung ultrasound; Pocket-size ultrasound device; Rheumatoid arthritis|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore MED/16 - Reumatologia
|Data di pubblicazione:||ago-2014|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/rheumatology/keu033|
|Appare nelle tipologie:||01 - Articolo su periodico|