Premium
Lung ultrasound imaging usefulness for assessing the severity of pulmonary fibrosis in systemic sclerosis. Relationship with high‐resolution computed tomography and nailfold videocapillaroscopy (LB514)
Author(s) -
Sperandeo Marco,
De Cata Angelo,
Molinaro Francesca,
Trovato Francesca M.,
Dimitri Lucia,
Catalano Daniela,
Simeone Anna,
Trovato Guglielmo
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.lb514
Subject(s) - medicine , honeycombing , lung , reticular connective tissue , high resolution computed tomography , pathology , radiology , fibrosis , interstitial lung disease
Thoracic UltraSound (TUS) assesses 70% of the subpleural areas. Systemic sclerosis (SSc) is characterized by collagen thickening of the skin and by early and progressive microcirculatory impairment. SSc microangiopathy, assessed in vivo by x200 magnification nailfold videocapillaroscopy (NVC), evolves from early enlargement of capillaries (giant capillaries) to capillary loss and hemorrhage (active pattern), and finally, to reactive neoangiogenesis, with capillary ramifications (late pattern). We aimed to assess concordance, if any, between TUS abnormalities, in any phase of disease, and High‐Resolution Computed Tomography (HRCT) findings in SSc, concurrently with the association of the NVC with TUS and HRCT patterns. Methods. 175 SSc patients (M 9, F 166), 46.46 ±15.33 years, were studied by chest x‐rays, TUS, HRCT, echocardiography, pulmonary function tests and NVC. Results. Among 38 patients with limited SSc, without respiratory symptoms, normal spirometry, normal diffusing capacity of the lung and 6‐min O 2 desaturation walk test, 17/38 show TUS pleural line thickening 蠅3.0 <5 mm with slight posterior‐basal reticular pattern at HRCT, 21/38 have normal pleural thickness (<3 mm) and normal HRCT. In diffuse SSc: 97/137 patients have minor pleural line thickening (蠅3.0 <5 mm), 32/97 with subpleural nodules; 35/137 have major pleural line thickening (蠅5.0 mm), all with traction cysts and nodules; 5/137 with pleural thickness <3.0 mm have a normal HRCT. By HRCT 65/97 with minor pleural thickening have diffuse reticular pattern fibrosis and 32/97 a reticular‐nodular pattern; no honeycombing. Among the 35 patients with major pleural thickening 蠅 5.0 mm, 2/35 patients show a reticular‐nodular pattern and 33/35, show a frank honeycombing pattern; accuracy of TUS at the reliability analysis is high. There is also an incremental severity of NVC patterns associated with greater pulmonary fibrosis severity at HRCT and TUS; nonetheless, NVC is not discriminating among the different HRCT severity of pulmonary fibrosis,being actually a comprehensive clue of disease activity. Conclusion. TUS imaging with its reproducible measures is a promising complementary tool for early detection of structural lung abnormalities allowing to refer patients selectively to HRCT or to delay referral.