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Role of Lung Ultrasound in detection and assessment of severity of ILD in patients with Systemic sclerosis 肺超声在系统性硬化症患者ILD严重程度的检测和评估中的作用
Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-09-09 DOI: 10.1183/13993003.congress-2023.pa1821
Richa Gupta, Davis Joseph K J, Avinash Nair, John Mathew, Manisha Mane
ABSTRACT TITLE: Role of Lung Ultrasound in detection and assessment of severity of ILD in patients with Systemic sclerosis BACKGROUND: HRCT Thorax is gold standard for diagnosing ILD but has limitations because of cost and radiation exposure issues. Lung Ultrasound (LUS) has shown to be useful alternative for diagnosing ILD. AIM: To find out the diagnostic yield of Lung Ultrasound to detect ILD in patients with SSc-ILD. METHODS: All consecutive patients with Systemic sclerosis underwent HRCT, Pulmonary Function Test and Lung Ultrasound (LUS). LUS was done by chest physician who was blinded to the clinical, physiological, and radiological status of the patient. Presence of B-lines (number and sites)and broken pleura sign were recorded as sonographic features of ILD and correlated with the Warrick score in HRCT. RESULTS: A total of 117 patients (103 women) were included in the study. The number of B-lines detected on thoracic USG showed significant positive correlation with the Warrick score on HRCT (r=0.947;p<0.001). A significant relationship between presence of broken pleural sign in LUS and severity of Warrick score in HRCT was also found (p <0.001). With HRCT as the gold standard: the sensitivity, specificity, positive predicted value, and negative predicted value for LUS were found to be 100%, 98%, 98.9%, and 100% respectively. CONCLUSIONS: LUS is a good alternative to HRCT Thorax for early diagnosing of SSc-ILD. We propose LUS can be used as a screening tool for diagnosing lung interstitial involvement. It can also be used as a follow up tool to look for disease progression of ILD in patients with Systemic sclerosis.
摘要:肺超声在系统性硬化症患者ILD严重程度检测和评估中的作用背景:HRCT胸腔检查是诊断ILD的金标准,但由于成本和辐射暴露问题存在局限性。肺超声(LUS)已被证明是诊断ILD的有用替代方法。目的:探讨肺超声对SSc-ILD患者ILD的诊断率。方法:所有连续系统性硬化症患者均行HRCT、肺功能检查和肺超声检查(LUS)。LUS由胸内科医生完成,他不知道患者的临床、生理和放射学状况。b线(数目和位置)和胸膜破裂征象被记录为ILD的声像图特征,并与HRCT的Warrick评分相关。结果:117例患者(103例女性)纳入研究。胸段USG上b线数量与HRCT Warrick评分呈显著正相关(r=0.947;p<0.001)。LUS胸膜破裂体征的存在与HRCT Warrick评分的严重程度之间也存在显著关系(p <0.001)。以HRCT为金标准:LUS的敏感性为100%,特异性为98%,阳性预测值为98.9%,阴性预测值为100%。结论:LUS是早期诊断SSc-ILD较好的替代HRCT胸腔镜检查方法。我们建议LUS可以作为诊断肺间质受累的筛查工具。它也可以作为一种随访工具,用于寻找系统性硬化症患者ILD的疾病进展。
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Ultrasound
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