肺部超声在系统性自身免疫性风湿病相关肺部受累中的多功能作用:叙述性综述

IF 4.9 2区 医学 Q1 Medicine Arthritis Research & Therapy Pub Date : 2024-09-18 DOI:10.1186/s13075-024-03399-2
Yukai Wang, Shaoqi Chen, Shaoyu Zheng, Zexuan Zhou, Weijin Zhang, Guangzhou Du, Angelina Mikish, Barbara Ruaro, Cosimo Bruni, Anna-Maria Hoffmann-Vold, Luna Gargani, Marco Matucci-Cerinic, Daniel E Furst
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引用次数: 0

摘要

与系统性自身免疫性风湿病(SARDs)相关的肺部疾病发病率很高,临床表现和行为多变,因此与不良预后相关,并对生活质量产生负面影响。胸部高分辨率计算机断层扫描(HRCT)仍被认为是筛查、诊断和随访 SARDs 患者肺部疾病的基本成像工具。然而,辐射暴露、经济负担以及缺乏床旁 CT 设备限制了它在某些临床情况下的应用。超声波在风湿病的许多方面都占有一席之地,包括血管、皮肤、肌肉、关节、肾脏以及恶性肿瘤的筛查。同样,它在肺部的应用也越来越广泛。在过去的二十年中,肺部超声开始用于肺实质疾病,如肺炎、肺水肿、肺纤维化、气胸和胸膜病变,尽管肺实质曾一度被认为是超声检查的禁区。现在,肺部超声 B 线和胸膜线不规则被认为是与弥漫性肺实质疾病有关的两个重要超声伪影,它们可以反映病变的范围和严重程度。然而,其在与 SARDs 相关的肺部受累治疗中的作用尚未得到充分研究。这篇综述文章将重点讨论肺部超声在与 SARDs 相关的不同肺部病变(如间质性肺病、弥漫性肺泡出血、膈肌受累和肺部感染)中的潜在应用,以探讨其在日常临床实践中的价值。
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A versatile role for lung ultrasound in systemic autoimmune rheumatic diseases related pulmonary involvement: a narrative review
Systemic autoimmune rheumatic diseases (SARDs) related pulmonary disease is highly prevalent, with variable clinical presentation and behavior, and thus is associated with poor outcomes and negatively impacts quality of life. Chest high resolution computed tomography (HRCT) is still considered a fundamental imaging tool in the screening, diagnosis, and follow-up of pulmonary disease in patients with SARDs. However, radiation exposure, economic burden, as well as lack of point-of-care CT equipment limits its application in some clinical situation. Ultrasound has found a place in numerous aspects of the rheumatic diseases, including the vasculature, skin, muscle, joints, kidneys and in screening for malignancies. Likewise it has found increasing use in the lungs. In the past two decades, lung ultrasound has started to be used for pulmonary parenchymal diseases such as pneumonia, pulmonary edema, lung fibrosis, pneumothorax, and pleural lesions, although the lung parenchymal was once considered off-limits to ultrasound. Lung ultrasound B-lines and irregularities of the pleural line are now regarded two important sonographic artefacts related to diffuse parenchymal lung disease and they could reflect the lesion extent and severity. However, its role in the management of SARDs related pulmonary involvement has not been fully investigated. This review article will focus on the potential applications of lung ultrasound in different pulmonary scenarios related with SARDs, such as interstitial lung disease, diffuse alveolar hemorrhage, diaphragmatic involvement, and pulmonary infection, in order to explore its value in clinical daily practice.
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来源期刊
CiteScore
8.60
自引率
2.00%
发文量
261
审稿时长
14 weeks
期刊介绍: Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.
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