Correlation between Lung Ultrasound, HRCT Findings and Pulmonary Function Tests in Primary Sjögren’s Syndrome (pSS)-Associated Interstitial Lung Disease

Francesco Ferro¹, Alessandra Bulleri², Andrea Delle Sedie¹, Simone Barsotti¹, Nicoletta Luciano¹, Elisa Cioffi³, Elena Elefante¹, Gianfranco Puppo⁴, Marta Mosca¹ and Chiara Baldini⁵, ¹Rheumatology Unit, University of Pisa, Pisa, Italy, ²Radiology Unit, University of Pisa, Pisa, Italy, ³Rheumatology Unit, Rheumatology Unit, University of Pisa, Pisa, Italy, ⁴Pneumology Unit, University of Pisa, Pisa, Italy, ⁵Internal Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Lung Disease, Sjogren's syndrome and ultrasonography

Session Information

Date: Monday, November 6, 2017

Title: Sjögren's Syndrome Poster II: Clinical Research

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Recently, pleural irregularity (PI), a new lung ultrasound (US) sign, has been proposed as an emerging tool for the diagnosis of interstitial lung disease (ILD) in connective tissue diseases. However, few data are available regarding its role in the evaluation of ILD associated to primary Sjögren’s syndrome (pSS). Aim of this study was to assess the accuracy of PI-US in detecting pSS-associated ILD by correlating PI-US findings with chest high-resolution computed tomography (HRTC) and pulmonary function tests.

Methods: Eighteen patients with pSS-associated ILD were included in the study. HRCT and tests of pulmonary function were performed in each patient. PI-US was performed by a single operator using a MyLab-25 (Esaote), 10 MHz, 5 cm linear probe. PI was defined as the loss of the normal hyperechoic linear pleural contour (score 0-2: normal, minimal and major changes at each intercostal space). PI US total score represented the sum of partial scores assigned to 6 lung fields (2 for the anterior, 2 for postero-superior and 2 for postero-inferior chest surface). Abnormal findings at HRCT were quantified by an expert radiologist according to the Warrick score.

Results: We included in this study 18 patients with pSS-related associated ILD (14 F:4 M, mean age =68.8 ±9.9 yrs). The median PI-US score was 45 (range 25.5-73.5). Both PI-US total score and partial postero-inferior PI-US score strongly correlated with the Warrick HRCT score (r= 0.813, p=0.000 and r= 0.914, p=0.000). Regarding pulmonary function tests, the Warrick HRCT score correlated with FVC (r=-0.753, p=0.001), TLC (r=-0.853, p=0.000), and DLCO (r=-0.834, p=0.000). Similarly, PI-US total score and partial PI-US postero-inferior score correlated inversely with FVC (r=-0.849, p=0.000 and r=-0.836, p=0.000), TLC (r=-0.895, p=0.000 and r=-0.829, p=0.000), and DLCO (r=-0.953, p=0.000 and r=-0.883, p=0.001). Finally, both PI-US score and PI-US of the infero-posterior field (but not Warrick HRCT score) directly correlated with FEV1/SVC (r=0.701, p=0.004 and r=0.619, p=0.01) and with FEV1/FVC (r=0.600, p=0.02 and r=0.501, p=0.05).

Conclusion: This study demonstrated a high correlation between PI-US, HRCT findings and pulmonary function tests, supporting the use of lung ultrasonography in clinical practice for the assessment of pSS-associated ILD. The exclusive correlation between PI-US scores and both FEV1/SVC and FEV1/FVC seemed to indicate a higher sensitivity of PI-US with respect to HRCT in ILD assessment. Further studies are warranted to clarify the role of PI-US for the early diagnosis of ILD.

Disclosure: F. Ferro, None; A. Bulleri, None; A. Delle Sedie, None; S. Barsotti, None; N. Luciano, None; E. Cioffi, None; E. Elefante, None; G. Puppo, None; M. Mosca, None; C. Baldini, None.

To cite this abstract in AMA style:

Ferro F, Bulleri A, Delle Sedie A, Barsotti S, Luciano N, Cioffi E, Elefante E, Puppo G, Mosca M, Baldini C. Correlation between Lung Ultrasound, HRCT Findings and Pulmonary Function Tests in Primary Sjögren’s Syndrome (pSS)-Associated Interstitial Lung Disease [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/correlation-between-lung-ultrasound-hrct-findings-and-pulmonary-function-tests-in-primary-sjogrens-syndrome-pss-associated-interstitial-lung-disease/. Accessed .

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