Clinical Application Of Lung Ultrasound In The Evaluation Of Connective Tissue Disease-Associated Interstitial Lung Disease

Objective:To observe the ultrasonographic features of lung ultrasound(LUS)in patients with connective tissue disease-related interstitial lung disease,and to compare it with the patient's pulmonary function test results and imaging gold standard chest High-resolution computed tomography(HRCT),in order to explore the clinical value of lung ultrasound in connective tissue disease-related interstitial lung disease.Methods:60 patients(34 females,26 males,mean age 57.12±7.29 years old)with primary or secondary connective tissue disease were enrolled in the rheumatology department of our hospital from 2017.7-2018.12,including rheumatoid 18 cases of arthritis,29 cases of systemic sclerosis,13 cases of Sjogren's syndrome,collected clinical data of pulmonary function tests in all patients,and performed chest HRCT and lung ultrasound(LUS)examination for all patients,each patient Ultrasound examination of the lungs was performed within one week after the chest HRCT scan.For each patient,a 50-rib gap and a 14-rib space were used to scan each patient.The pleural line and B-line of each intercostal space were mainly observed.recording the time spent by the two methods,storing maps and recording them.Finally,the results of pulmonary ultrasound were compared with the results of chest HRCT and pulmonary function tests to explore the value of lung ultrasound in evaluating connective tissue disease-related interstitial lung disease,and to compare the two methods of lung ultrasound scanning,which method is more time-saving and efficient.Results:1.Among the 60 patients with connective tissue disease who met the inclusion criteria,48 cases were diagnosed as connective tissue disease-associated interstitial lung disease by chest HRCT.The pulmonary ultrasound images of 48 patients showed irregular pleural line and a large number of B-line.2.The lung ultrasound results and chest high-resolution CT(HRCT)were compared in 60 patients.The results showed no significant difference(P>0.05).The more severe the chest HRCT manifestations,the more the number of B-lines on the corresponding pulmonary ultrasound images.3.The number of B-lines in LUS was negatively correlated with FVC(r=-0.844,P=0.000)and DLCO(r=-0.834,P=0.000).The more B-lines in patients with poor lung function.and the number of lung ultrasound B lines in patients with poor lung function.4.Comparing the B-line score and scanning time of 50-rib space and 14-rib space of lung ultrasound,the results showed that there was no significant difference in B-line score between the two methods(P > 0.05),but there was significant difference in scanning time between the two methods(P < 0.05).Conclusion:The pulmonary ultrasound sonogram of connective tissue disease-associated interstitial lung disease is mainly characterized by irregular pleural line and a large number of B-lines.Lung ultrasound evaluation of connective tissue disease-related interstitial lung disease is in good agreement with HRCT.The number and score of B-line in lung ultrasound can indicate the severity of pulmonary interstitial involvement.The more B-line,the more serious pulmonary lesions.The number of B-lines of LUS was negatively correlated with FVC and DLCO of lung function.The 14-rib gap scanning method is shorter and easier than the 50-rib gap scanning method.Therefore,the use of lung ultrasonography may have important clinical application value for early screening,disease assessment and treatment follow-up of patients with connective tissue disease interstitial lung disease.