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2017 ; 19
(1
): 206
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Usefulness of lung ultrasound B-lines in connective tissue disease-associated
interstitial lung disease: a literature review
#MMPMID28923086
Wang Y
; Gargani L
; Barskova T
; Furst DE
; Cerinic MM
Arthritis Res Ther
2017[Sep]; 19
(1
): 206
PMID28923086
show ga
Interstitial lung disease (ILD) is a major pulmonary manifestation of connective
tissue disease (CTD), leading to significant morbidity and mortality. Chest
high-resolution computed tomography (HRCT) is presently considered the diagnostic
gold standard for pulmonary fibrosis diagnosis and quantification in the clinical
arena. However, not negligible doses of ionizing radiation limit the use of HRCT,
especially for serial follow-up in younger female patients. In the past decade,
lung ultrasound (LUS) has been proposed to assess ILD by detecting and
quantifying sonographic B-lines. Previous studies demonstrate that B-lines have a
good diagnostic accuracy, especially high sensitivity, and correlate well with
HRCT findings, suggesting LUS as a novel, non-invasive, and non-ionizing imaging
method to be used in patients with CTD-ILD. Although preliminary data are
promising, challenges and controversies still remain. For example, the mechanisms
of B-line generation are not fully understood; the diagnostic accuracy and
performance characteristics of LUS partially depend on the scanning scheme and
scoring system used; and up-to-date B-lines cannot discriminate the early
cellular inflammation from the chronic fibrotic phase in CTD-ILD. Therefore it is
important for clinicians to understand the strengths and limitations of LUS in
CTD-ILD patients, to maximize its value.