Pleural Irregularities: A new ultrasound marker for lung involvement in primary Sjögren's disease

IF 3.8 3区医学 Q1 RHEUMATOLOGY

Joint Bone Spine Pub Date : 2024-11-17 DOI:10.1016/j.jbspin.2024.105820

Francesco Ferro , Gaetano La Rocca , Elena Elefante , Gianluca Sambataro , Alessandra Tripoli , Gianmaria Governato , Giovanni Fulvio , Michele Moretti , Alessandra Bulleri , Chiara Romei , Marta Mosca , Chiara Baldini

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引用次数: 0

Abstract

Objectives

Lung ultrasound (LUS) has been proposed as a useful tool for the assessment of interstitial lung disease (ILD) in connective tissue diseases. However, there are no studies investigating the significance of pleural irregularities (PI) on LUS in primary Sjögren's disease (SjD) patients. The aim of this study was to explore the role of PI for the assessment of SjD-related lung involvement.

Methods

All primary SjD patients who had undergone a chest CT-scan in the lasts 2 months from the start of the study were enrolled, including both SjD patients with known ILD and SjD patients without known lung involvement who underwent a chest CT due to clinical indications other than ILD screening. LUS was performed for all patients and PI total and partial scores were assigned from 0 (normal) to 2 (major changes). Based on CT-scans results SjD patients were divided into 5 groups: normal CT-scan, non SjD-related lung abnormalities, SjD-related non-ILD lung abnormalities, established ILD, newly diagnosed ILD.

Results

Nineteen SjD patients with established ILD and 42 without known lung involvement who had undergone a CT-scan were included. Among the latter, CT allowed the diagnosis of 4 new ILD cases. Both total and postero-inferior PI scores were comparable between established ILD and newly diagnosed ILD patients and significantly higher compared to patients with normal CT-scan and SjD related non-ILD lung abnormalities. The AUC for ILD diagnosis was significantly higher for the PI postero-inferior score compared to the PI total score. A cut-off score of 15 for the PI postero-inferior score resulted in a sensitivity of 86.6% and specificity of 84.2% for SjD-ILD diagnosis. Both PI total and postero-inferior scores strongly correlated with HRCT Warrick score (r = 0.809 and r = 0.854). The correlation between PFT and both total and postero-inferior PI scores was higher than that observed between PFT and the Warrick HRCT score.

Conclusions

PI may represent a valid tool for the assessment of lung involvement in SjD, particularly for the screening of ILD. PI assessment limited to postero-inferior lung fields seem to maintain good diagnostic accuracy, allowing to save time in clinical practice.

查看原文本刊更多论文

胸膜不规则：原发性斯约格伦病肺部受累的新超声标记。

目的：肺部超声（LUS）被认为是评估结缔组织疾病间质性肺病（ILD）的有效工具。然而，目前还没有研究调查胸膜不规则（PI）对原发性斯约格伦病（SjD）患者肺部超声波检查的意义。本研究旨在探讨 PI 在评估 SjD 相关肺部受累中的作用：所有在研究开始后 2 个月内接受过胸部 CT 扫描的原发性 SjD 患者都被纳入了研究范围，其中包括已知 ILD 的 SjD 患者，以及因 ILD 筛查以外的临床指征而接受胸部 CT 检查但未发现肺部受累的 SjD 患者。所有患者都进行了 LUS 检查，PI 总分和部分分数从 0（正常）到 2（重大变化）不等。根据 CT 扫描结果，SjD 患者被分为 5 组：CT 扫描正常、与 SjD 无关的肺部异常、与 SjD 无关的非 ILD 肺部异常、已确诊的 ILD、新诊断的 ILD。在后者中，CT 可诊断出 4 例新的 ILD。已确诊的 ILD 患者和新确诊的 ILD 患者的 PI 总分和后下 PI 分值相当，与 CT 扫描正常和 SjD 相关的非 ILD 肺部异常患者相比，PI 总分和后下 PI 分值明显较高。与 PI 总分相比，PI 后下部评分诊断 ILD 的 AUC 明显更高。PI 后内侧评分的临界值为 15 分时，SjD-ILD 诊断的灵敏度为 86.6%，特异度为 84.2%。PI 总分和后内侧评分均与 HRCT Warrick 评分密切相关（r= 0.809 和 r=0.854）。PFT与PI总分和后内侧得分之间的相关性高于PFT与HRCT Warrick评分之间的相关性：结论：PI可能是评估SjD肺部受累情况的有效工具，尤其是用于筛查ILD。仅限于后下叶肺野的 PI 似乎能保持良好的诊断准确性，从而在临床实践中节省时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Joint Bone Spine 医学-风湿病学

CiteScore

4.50

自引率

11.90%

发文量

184

审稿时长

25 days

期刊介绍： Bimonthly e-only international journal, Joint Bone Spine publishes in English original research articles and all the latest advances that deal with disorders affecting the joints, bones, and spine and, more generally, the entire field of rheumatology. All submitted manuscripts to the journal are subjected to rigorous peer review by international experts: under no circumstances does the journal guarantee publication before the editorial board makes its final decision. (Surgical techniques and work focusing specifically on orthopedic surgery are not within the scope of the journal.)Joint Bone Spine is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.