title: Lung ultrasound for the screening of interstitial lung disease in very early systemic sclerosis.
abstract: BACKGROUND
  A high percentage of patients with systemic sclerosis (SSc) develop interstitial lung disease (ILD) during the course of the disease. Promising data have recently shown that lung ultrasound (LUS) is able to detect ILD by the evaluation of B-lines (previously called ultrasound lung comets), the sonographic marker of pulmonary interstitial syndrome.
  
  
  OBJECTIVE
  To evaluate whether LUS is reliable in the screening of ILD in patients with SSc.
  
  
  METHODS
  Fifty-eight consecutive patients with SSc (54 women, mean age 51±14 years) who underwent a high resolution CT (HRCT) scan of the chest were also evaluated by LUS for detection of B-lines. Of these, 32 patients (29 women, mean age 51±15 years) fulfilled the criteria for a diagnosis of very early SSc.
  
  
  RESULTS
  At HRCT, ILD was detected in 88% of the SSc population and in 41% of the very early SSc population. A significant difference in the number of B-lines was found in patients with and without ILD on HRCT (57±53 vs 9±9; p<0.0001), with a concordance rate of 83%. All discordant cases were false positive at LUS, providing a sensitivity and negative predictive value of 100% in both SSc and very early SSc.
  
  
  CONCLUSIONS
  ILD may be detected in patients with very early SSc. The presence of B-lines at LUS examination correlates with ILD at HRCT. LUS is very sensitive for detecting ILD even in patients with a diagnosis of very early SSc. The use of LUS as a screening tool for ILD may be feasible to guide further investigation with HRCT.
authors.affiliation: Department of Biomedicine, Division of Rheumatology, AOUC, Excellence Centre for Research, Transfer and High Education DENOthe, University of Florence, Via Pieraccini, 18-50139, Firenze, Italy. tbarskova@gmail.com
authors.forename: Tatiana
authors.initials: T
authors.lastname: Barskova
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.forename: Serena
authors.initials: S
authors.lastname: Guiducci
authors.forename: Silvia Bellando
authors.initials: SB
authors.lastname: Randone
authors.forename: Cosimo
authors.initials: C
authors.lastname: Bruni
authors.forename: Giulia
authors.initials: G
authors.lastname: Carnesecchi
authors.forename: Maria Letizia
authors.initials: ML
authors.lastname: Conforti
authors.forename: Francesco
authors.initials: F
authors.lastname: Porta
authors.forename: Alberto
authors.initials: A
authors.lastname: Pignone
authors.forename: Davide
authors.initials: D
authors.lastname: Caramella
authors.forename: Eugenio
authors.initials: E
authors.lastname: Picano
authors.forename: Marco Matucci
authors.initials: MM
authors.lastname: Cerinic
mesh_terms: D042241:Early Diagnosis; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000150:complications* / Q000000981:diagnostic imaging*; D014463:Ultrasonography