Ultrasonographic pulmonary evaluation in systemic sclerosis and control group with acr/eular criteria and high-resolution computed tomography
- MOJ Orthopedics & Rheumatology
José Alexandre Mendonça,1 Fabia Mara Goncalves Prates de Oliveira,2 Nilzio Antonio da Silva3
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The objectives of this study were to evaluate changes in the lung parenchyma in systemic sclerosis (SS) using ultrasonography; associate this findings with the clinical criteria and high-resolution computed tomography (HRCT). Methods: Thirty SS outpatients of two public hospitals in Brazil and ten healthy subjects underwent pulmonary ultrasound (US) examination, evaluating pulmonary parenchyma alterations in 14 intercostal spaces. The B-lines, structures indicative of pleural septal thickening, when present, were graded by a simplified score. HRCT of lung carried out previously were correlated with lung ultrasound. Results: Changes in pulmonary parenchyma seen by the US in such population were the B-lines, present in 96.67% of the patients. The classification of pulmonary US in this group was normal in 16.67%, mild in 30%, moderate in 36.67% and marked in 16.67% of the cases. Pulmonary US sensitivity in this study was 93% and specificity 77%. Patients with SS in the diffuse form had a higher number of B-lines than those in limited form. Correlation between pulmonary US and the number of B-lines was positive r=0.95; (p<0.001). HRCT scans with reports of pulmonary fibrosis presented more B-lines, r=0.54; (p=0.006). In the correlation between the semiquantitative US lung score and the ACR / EULAR Classification Criteria 2013, there was significant agreement (p = 0.010). Conclusion: The pulmonary parenchyma changes in SS identified through the US in this work were the B-lines. Pulmonary US with semiquantitative B-line score presented high sensitivity for interstitial lung disease (ILD) investigation. The manifestation of diffuse pulmonary parenchymal disease seen by the pulmonary US of this population was compatible with the results of previous studies.
ultrasonography; ultrasound; systemic sclerosis; lung; interstitial lung disease, pulmonary fibrosis