AB1372 SPECIFICITY AND SENSITIVITY OF LUNG ULTRASOUND (LUS) IN RHEUMATIC DISEASES ON RUSSIAN COHORTS OF PATIENTS

Abstract

BackgroundPulmonary disease is one of the most relevant with interstitial lung disease (ILD) being one of the most frequents forms of involvement with resultant worsening of morbidity and mortality in disorders such as systemic sclerosis (SSc), rheumatoid arthritis (RA), or inflammatory myopathies. High-resolution computed tomography (HRCT), which is the current gold standard for diagnosis and evolutionary control, is problematic owing to ionizing radiation, cost, and accessibility. In this context, lung ultrasound (LUS) is an attractive tool in a growing research and validation process.Objectivesto assess specificity and sensitivity of LUS in rheumatic diseases on Russian cohorts of patients.Methods110 pts with ILD of rheumatic disease such as: systemic sclerosis (n=60) (mean age 49.8±13.3, fem 57); vasculitis n=11 (mean age 40.7± 9.1, fem 5); dermatomyositis (DM), anti-synthetase syndrome (ASS), polymyositis (PM) n=20, (mean age 48.7± 11.9, fem 13); rheumatoid arthritis (RA) n=9 (mean age 56.5± 6.3, fem 7); Sjogren’s syndrome (SSj) n=9 (mean age 59.6± 12.3, fem 8). Chest HRCT were evaluated. Control group (n=30) without rheumatic diseases and ILD (mean age 51.4± 15.4, fem 24); (chest X-ray (CXR) were evaluated). LUS examination protocol that include the anterior, lateral, and/or posterior thorax have been suggested. The B-lines score denoting the extension of ILD was calculated by summing the number of B-lines on a total of 58 scanning sites. In each patient ultrasound comets (ULC) score was obtained by summing the number of comets detected as previously recommended. The data were collected in protocols for statistical testing. The diagnostic accuracy LUS is expressed as sensitivity, specificity. ROC (receiver operating characteristic) curves and AUCs (areas under curve) were used of analyze the accuracy of B-lines in recognizing the presence of ILD on HRCT.Resultsthe analysis included all the 110 patients enrolled in the study. ROC cure analysis the ULC score of anterior chest area was (AUC =0.876; 95% CI 0.82-0.96; p<0.0001); ROC cure analysis the ULC score of posterior chest area was (AUC =0.908; 95% CI 0.858-0.958; p<0.0001); ROC cure analysis for the total ULC score was (AUC =0.932; 95% CI 0.892-0.972; p<0.0001).Accuracy of echographic signs (B-line) in the different chest areas in the detection of interstitial lung disease (Table 1).Table 1.Total B-line Score (TBLS)SensitivitySpecificityAnterior chest area>561.8%96%>1048.2%100%Posterior chest area>585.5%83%>1073.6%90%All chest areas>589.1%70%>1081.8%87%Using the TBLS to identify a positive LUS examination, sensitivity and specificity were different depending on the area investigation. The best results were in the posterior area and all chest areas.Conclusionour research documented the high diagnostic accuracy of LUS in the detection of ILD. Our findings support the use of LUS a sensitive tool for ILD detection, especially considering that it’s an inexpensive and nonionizing technique.Disclosure of InterestsNone declared