Purpose: We investigated the clinical applicability of TUS in patients with systemic sclerosis in order to identify echo-patterns of pulmonary fibrosis.
Methods: 101 consecutive patients (92 females; median age 67 yrs) affected by systemic sclerosis were enrolled between January 2003 and November 2008.
All the patients underwent TUS with an 3.5 MHz convex scanner and a multifrequency (8-12 MHz) linear scanner. Sonography was conducted in every and dorsal intercostal spaces with patients in seated or lying position. All examinations were done by a single physician experienced with TUS. The obtained data were compared with those from a sample of 162 healthy subjects (134 women; median age 56 yrs).
All patients also had standard anteroposterior and lateral chest radiography, HRCT, and pulmonary function tests.
Results: In patients with pulmonary fibrosis the echo-pattern were:
1-fragmented and irregular thickness of the “pleural line” distributed over the whole surface of the lung, especially in the lower posterior lobe ( in all patients independently by the severity or the etiology of the disease)
2-subpleuric cistys
3-a slackening of the physiological “gliding or sliding sign” related to the stage of the disorder
4-failure of diaphragmatic movements usually observed on right hemithorax in supine position (end stage)
5-numerous reverberation artifacts , best visible under real time conditions ( advance stage)
These abnormalities were detected on both sides of the lung and were compared with HRCT.
Conclusions: TUS is a useful technique to document early and late-state lung changes in patients with systemic sclerosis.