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类风湿关节炎患者肺部受累的超声表现及解剖分布

Ultrasonographic Presentation and Anatomic Distribution of Lung Involvement in Patients with Rheumatoid Arthritis.

作者信息

Vermant Marie, Kalkanis Alexandros, Goos Tinne, Cypers Heleen, De Crem Nico, Neerinckx Barbara, Taelman Veerle, Verschueren Patrick, Wuyts Wim A

机构信息

Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism, Katholieke Universiteit Leuven, Herestraat 49, 3000 Leuven, Belgium.

Department of Pulmonology, University Hospitals Leuven, 3000 Leuven, Belgium.

出版信息

Diagnostics (Basel). 2023 Sep 18;13(18):2986. doi: 10.3390/diagnostics13182986.


DOI:10.3390/diagnostics13182986
PMID:37761353
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10529908/
Abstract

BACKGROUND: Rheumatoid arthritis (RA) is a chronic auto-immune disease, typically affecting the joints, which can also present with lung involvement (pleuritis, interstitial lung disease, pulmonary nodules, etc.). Lung ultrasound (LUS) is an upcoming tool in the detection of these pulmonary manifestations. METHODS: We performed a 72-window LUS in 75 patients presenting to the outpatient rheumatology clinic and describe the abnormalities (presence of B-lines (vertical comet-tail artefacts), pleural abnormalities, pleural effusions, and subpleural nodules) on lung ultrasound. We created a topological mapping of the number of B-lines per intercostal zone. RESULTS: We observed pleural effusions, pleural abnormalities, and pleural nodules in, respectively, 1.3%, 45.3%, and 14% of patients. There were 35 (46.7%) patients who had less than 5 B-lines, 15 (20%) patients who had between 5 and 10 B-lines, 11 (14.6%) between 10 and 20, 10 (13.3%) between 20 and 50, 1 (1.3%) between 50 and 100, and 3 (4%) of patients who had more than 100 B-lines. CONCLUSIONS: LUS in patients with RA shows an array of abnormalities ranging from interstitial syndromes to pleural abnormalities, subpleural nodules, and pleural effusions. Hotspots for the presence of B-lines are situated bilaterally in the posterior subscapular regions, as well as the anterior right mid-clavicular region.

摘要

背景:类风湿性关节炎(RA)是一种慢性自身免疫性疾病,通常影响关节,也可出现肺部受累(胸膜炎、间质性肺疾病、肺结节等)。肺部超声(LUS)是检测这些肺部表现的一种新兴工具。 方法:我们对75名到门诊风湿病诊所就诊的患者进行了72窗格肺部超声检查,并描述了肺部超声检查中的异常情况(B线(垂直彗尾伪像)的存在、胸膜异常、胸腔积液和胸膜下结节)。我们创建了每个肋间区域B线数量的拓扑图。 结果:我们分别在1.3%、45.3%和14%的患者中观察到胸腔积液、胸膜异常和胸膜结节。有35名(46.7%)患者的B线少于5条,15名(20%)患者的B线在5至10条之间,11名(14.6%)在10至20条之间,10名(13.3%)在20至50条之间,1名(1.3%)在50至100条之间,3名(4%)患者的B线超过100条。 结论:RA患者的肺部超声显示出一系列异常,从间质性综合征到胸膜异常、胸膜下结节和胸腔积液。B线存在的热点区域位于双侧肩胛下后部区域以及右锁骨中前部区域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/558a99dd2ab2/diagnostics-13-02986-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/38e25c13c297/diagnostics-13-02986-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/c55da58878bf/diagnostics-13-02986-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/558a99dd2ab2/diagnostics-13-02986-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/38e25c13c297/diagnostics-13-02986-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/c55da58878bf/diagnostics-13-02986-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b06/10529908/558a99dd2ab2/diagnostics-13-02986-g003.jpg

相似文献

[1]
Ultrasonographic Presentation and Anatomic Distribution of Lung Involvement in Patients with Rheumatoid Arthritis.

Diagnostics (Basel). 2023-9-18

[2]
Utility of pulmonary ultrasound to identify interstitial lung disease in patients with rheumatoid arthritis.

Clin Rheumatol. 2021-6

[3]
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[4]
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[5]
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[6]
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Clin Exp Rheumatol. 2022-3

[7]
[The subclinical involvement of the lung in rheumatoid arthritis: evaluation by high-resolution computed tomography].

Reumatismo. 2001

[8]
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Rheumatol Ther. 2021-12

[9]
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J Clin Med. 2024-6-17

[10]
The role of lung ultrasound B-lines and serum KL-6 in the screening and follow-up of rheumatoid arthritis patients for an identification of interstitial lung disease: review of the literature, proposal for a preliminary algorithm, and clinical application to cases.

Arthritis Res Ther. 2021-8-14

引用本文的文献

[1]
A Proposal for a New Lung Ultrasound Score in Rheumatoid Arthritis: The Reliability of Lung Ultrasound for Rheumatoid Arthritis-Associated Interstitial Lung Disease Diagnosis.

J Clin Med. 2025-5-25

[2]
Review of pulmonary manifestations of rheumatoid arthritis.

Skeletal Radiol. 2025-5-17

[3]
Lung ultrasound outperforms symptom-based screening to detect interstitial lung disease associated with rheumatoid arthritis.

RMD Open. 2025-2-26

[4]
The Burden of Interstitial Lung Involvement in Rheumatoid Arthritis: Could Lung Ultrasound Have a Role in Its Detection? A Literature Review.

Diagnostics (Basel). 2024-7-4

本文引用的文献

[1]
A Narrowing Mortality Gap: Temporal Trends of Cause-Specific Mortality in a National Matched Cohort Study in US Veterans With Rheumatoid Arthritis.

Arthritis Care Res (Hoboken). 2023-8

[2]
Lung Ultrasound B-Lines in the Evaluation of the Extent of Interstitial Lung Disease in Systemic Sclerosis.

Diagnostics (Basel). 2022-7-12

[3]
Lung Ultrasound for Pleural Line Abnormalities, Confluent B-Lines, and Consolidation: Expert Reproducibility and a Method of Standardization.

J Ultrasound Med. 2022-8

[4]
Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management.

Eur Respir Rev. 2021-6-30

[5]
Use of ultrasound to diagnose and monitor interstitial lung disease in rheumatic diseases.

Clin Rheumatol. 2021-9

[6]
Performance of semi-quantitative lung ultrasound in the assessment of disease severity in interstitial lung disease.

Ann Thorac Med. 2021

[7]
Utility of pulmonary ultrasound to identify interstitial lung disease in patients with rheumatoid arthritis.

Clin Rheumatol. 2021-6

[8]
Interobserver Agreement of Lung Ultrasound Findings of COVID-19.

J Ultrasound Med. 2021-11

[9]
Development and Assessment of Novel Lung Ultrasound Interpretation Criteria for the Detection of Interstitial Lung Disease in Systemic Sclerosis.

Arthritis Care Res (Hoboken). 2021-9

[10]
Prognostic Value of Lung Ultrasound B-Lines in Systemic Sclerosis.

Chest. 2020-10

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