Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis.
OBJECTIVE
To assess the correlation between ultrasound lung comets (ULCs, a recently described echographic sign of interstitial lung fibrosis) and the current undisputed gold-standard high-resolution CT (HRCT) to detect pulmonary fibrosis in patients with SSc.


METHODS
We enrolled 33 consecutive SSc patients (mean age 54 +/- 13 years, 30 females) in the Rheumatology Clinic of the University of Pisa. We assessed ULCs and chest HRCT within 1 week independently in all the patients. ULC score was obtained by summing the number of lung comets on the anterior and posterior chest. Pulmonary fibrosis was quantified by HRCT with a previously described 30-point Warrick score.


RESULTS
Presence of ULCs (defined as a total number more than 10) was observed in 17 (51%) SSc patients. Mean ULC score was 37 +/- 50, higher in the diffuse than in the limited form (73 +/- 66 vs 21 +/- 35; P < 0.05). A significant positive linear correlation was found between ULCs and Warrick scores (r = 0.72; P < 0.001).


CONCLUSIONS
ULCs are often found in SSc, are more frequent in the diffuse than the limited form and are reasonably well correlated with HRCT-derived assessment of lung fibrosis. They represent a simple, bedside, radiation-free hallmark of pulmonary fibrosis of potential diagnostic and prognostic value.
Gargani
Luna
L
Institute of Clinical Physiology, National Research Council, Via G. Moruzzi, 1, 56124, Pisa, Italy. gargani@ifc.cnr.it
Doveri
Marica
M
D'Errico
Luigia
L
Frassi
Francesca
F
Bazzichi
Maria L
ML
Delle Sedie
Andrea
A
Scali
Maria C
MC
Monti
Simonetta
S
Mondillo
Sergio
S
Bombardieri
Stefano
S
Caramella
Davide
D
Picano
Eugenio
E
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012129:Respiratory Function Tests; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography