Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders - preliminary resultsReport as inadecuate

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Arthritis Research and Therapy

, 13:R134

First Online: 18 August 2011Received: 07 March 2011Revised: 12 July 2011Accepted: 18 August 2011


IntroductionInterstitial pulmonary fibrosis IPF is a frequent manifestation in patients with connective tissue disorders CTD.
Recently the ultrasound US criterion validity for its assessment has been proposed; however, the US scoring systems adopted include the study of several lung intercostal spaces LIS, which could be time-consuming in daily clinical practice.
The aim of this study was to investigate the utility of a simplified US B-lines scoring system compared with both the US comprehensive assessment and the high-resolution computed tomography HRCT findings of IPF in CTD patients.

MethodsThirty-six patients with a diagnosis of CTD were enrolled.
Each patient underwent chest HRCT and lung US by an experienced radiologist and rheumatologist, respectively.
Both comprehensive and simplified US B-lines assessments were scanned.
The comprehensive US assessment was performed at 50 LIS level, whereas the simplified US assessment included bilaterally 14 LIS; for the anterior chest: the second LIS along the para-sternal lines, the fourth LIS along the mid-clavear, anterior axillary and mid-axillary lines; for the posterior chest: the eighth LIS along the paravertebral, sub-scapular and posterior axillary lines.

For criterion validity, HRCT was considered the gold standard.
Feasibility, inter and intra-observer reliability was also investigated.

ResultsA highly significant correlation between comprehensive and simplified US assessment was found P = 0.0001.
A significant correlation was also found between the simplified US assessment and HRCT findings P = 0.0006.
Kappa values for the inter-observer simplified US assessment were in a range from 0.769 to 0.885, whereas the concordance correlation coefficient values for the intra-observer were from 0.856 to 0.955.
There was a relevant difference in time spent on comprehensive mean 23.3 ± SD 4.5 minutes with respect to the simplified US assessment mean 8.6 ± SD 1.4 P < 0.00001.

ConclusionsOur results provide a new working hypothesis in favor of the utility of a simplified US B-lines assessment as an adjunct method to assess IPF in patients with CTD.

AbbreviationsCTDconnective tissue disorders

DLcodiffusing capacity for carbon monoxide

HRCThigh-resolution computed tomography

IPFinterstitial pulmonary fibrosis

LISlung intercostal spaces

SDstandard deviation


Electronic supplementary materialThe online version of this article doi:10.1186-ar3446 contains supplementary material, which is available to authorized users.

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Author: Marwin Gutierrez - Fausto Salaffi - Marina Carotti - Marika Tardella - Carlos Pineda - Chiara Bertolazzi - Elisabetta Bichi

Source: https://link.springer.com/


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