The promising role of lung ultrasound in systemic sclerosis

Sedie, Andrea Delle; Carli, L.; Cioffi, Elisa; Bombardieri, Stefano; Riente, Lucrezia

doi:10.1007/s10067-012-2030-4

Cited by 31 publications

(39 citation statements)

References 34 publications

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“…Finally, no data are available on large normal populations to confirm the cut-off points and PPV and NPV for this technique in SSc, RA, and other CTDs [ 47 – 50 ].…”

Section: Limitationsmentioning

confidence: 99%

Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: a literature review

et al. 2017

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Interstitial lung disease (ILD) is a major pulmonary manifestation of connective tissue disease (CTD), leading to significant morbidity and mortality. Chest high-resolution computed tomography (HRCT) is presently considered the diagnostic gold standard for pulmonary fibrosis diagnosis and quantification in the clinical arena. However, not negligible doses of ionizing radiation limit the use of HRCT, especially for serial follow-up in younger female patients. In the past decade, lung ultrasound (LUS) has been proposed to assess ILD by detecting and quantifying sonographic B-lines. Previous studies demonstrate that B-lines have a good diagnostic accuracy, especially high sensitivity, and correlate well with HRCT findings, suggesting LUS as a novel, non-invasive, and non-ionizing imaging method to be used in patients with CTD-ILD. Although preliminary data are promising, challenges and controversies still remain. For example, the mechanisms of B-line generation are not fully understood; the diagnostic accuracy and performance characteristics of LUS partially depend on the scanning scheme and scoring system used; and up-to-date B-lines cannot discriminate the early cellular inflammation from the chronic fibrotic phase in CTD-ILD. Therefore it is important for clinicians to understand the strengths and limitations of LUS in CTD-ILD patients, to maximize its value.

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“…Finally, no data are available on large normal populations to confirm the cut-off points and PPV and NPV for this technique in SSc, RA, and other CTDs [ 47 – 50 ].…”

Section: Limitationsmentioning

confidence: 99%

Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: a literature review

et al. 2017

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“…Various scanning techniques were proposed to reduce the dose (Mayo 2009). Intercostal ultrasound can be used to avoid ionizing radiations during follow-ups (Delle Sedie, et al 2012). However, it is not able to quantify the stiffness of lung.…”

Section: Introductionmentioning

confidence: 99%

An Ultrasound Surface Wave Technique for Assessing Skin and Lung Diseases

Zhang

Zhou

Kalra

et al. 2018

Ultrasound in Medicine & Biology

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Systemic sclerosis (SSc) is a multi-organ connective tissue disease characterized by immune dysregulation and organ fibrosis. Severe organ involvement, especially of the skin and lung, is the cause of morbidity and mortality in SSc. Interstitial lung disease (ILD) includes multiple lung disorders in which the lung tissue is fibrotic and stiffened. The purpose of this study was to translate ultrasound surface wave elastography (USWE) for assessing patients with SSc and/or ILD via measuring surface wave speeds of both skin and superficial lung tissue. Forty-one patients with both SSc and ILD and 30 healthy patients were enrolled in this study. An external harmonic vibration was used to generate the wave propagation on the skin or lung. Three excitation frequencies of 100, 150 and 200 Hz were used. An ultrasound probe was used to measure the wave propagation in the tissue non-invasively. Surface wave speeds were measured on the forearm and upper arm of both left and right arm, as well as the upper and lower lungs, through six intercostal spaces of patients and healthy patients. Viscoelasticity of the skin was calculated by the wave speed dispersion with frequency using the Voigt model. The magnitudes of surface wave speed and viscoelasticity of patients' skin were significantly higher than those of healthy patients (p<0.0001) for each location and each frequency. The surface wave speeds of patients' lung were significantly higher than those of healthy patients (p <0.0001) for each location and each frequency. USWE is a non-invasive and non-ionizing technique for measuring both skin and lung surface wave speed and may be useful for quantitative assessment of SSc and/or ILD.

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“…Lung ultrasound is inexpensive, widely available, reproducible and easily performed at the bedside, in combination with echocardiography [31,32]. When examined against lung HRCT, lung ultrasound has a high sensitivity and negative predictive value for ILD [31,32,33], but it has yet to be validated in the monitoring of ILD progression and has no routine clinical role in the outpatient clinic.…”

Section: Imaging In Monitoringmentioning

confidence: 99%

Monitoring of Lung Involvement in Rheumatologic Disease

Paschalaki

Jacob²,

Wells

2016

Respiration

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The monitoring of lung involvement in patients with connective tissue diseases is central to optimal long-term management and is directed towards: (a) the detection of supervening lung involvement not present at presentation and (b) the identification of disease progression in established lung disease. For both goals, accurate surveillance requires multi-disciplinary evaluation with the integration of symptomatic change, serial pulmonary function trends and imaging data. Evaluated in isolation, each of these monitoring domains has significant limitations. Symptomatic change may be confounded by a wide variety of systemic factors. Pulmonary function tests provide the most reliable data, but are limited by measurement variability, the heterogeneity of functional patterns and the confounding effects of non-pulmonary factors. Chest radiography is insensitive to change but may provide rapid confirmation of major disease progression or alert the clinician to respiratory co-morbidities. Although high-resolution computed tomography has a central role in assessing disease severity, it should be used very selectively as a monitoring tool due to the associated radiation burden. Ancillary tests include echocardiography and exercise testing to proactively identify cases of pulmonary hypertension and worsening of oxygenation. In summary, a multi-disciplinary approach is essential for the identification of disease progression and prompt treatment of comorbidities that severely impact on the morbidity and mortality of disease.

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The promising role of lung ultrasound in systemic sclerosis

Cited by 31 publications

References 34 publications

Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: a literature review

Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: a literature review

An Ultrasound Surface Wave Technique for Assessing Skin and Lung Diseases

Monitoring of Lung Involvement in Rheumatologic Disease

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