Utilidad del ultrasonido para el diagnóstico de enfermedad pulmonar intersticial en enfermedades difusas del tejido conectivo / Ultrasound for diagnosis of interstitial lung disease in diffuse connective tissue diseases

Las enfermedades difusas del tejido conectivo con frecuencia desarrollan enfermedad pulmonar intersticial, lo que conlleva peor pronóstico y acorta la supervivencia. La tomografía axial computarizada de alta resolución es la prueba diagnóstica de elección, ya que esta es muy competitiva con la histopatología; sin embargo, el costo y la radiación pueden limitar su empleo, particularmente como escrutinio. El ultrasonido pulmonar, estudio rápido, de acceso fácil, reproducible y de menor costo, resulta muy atractivo para determinar la existencia de enfermedad pulmonar intersticial. Adicionalmente, se requiere de poca experiencia para determinar las alteraciones correlacionables con estos padecimientos pulmonares. Las líneas B y las irregularidades pleurales conforman el denominado síndrome intersticial ultrasonográfico, aunque debemos tener en mente que no es específico y estamos obligados a considerar anormalidades hemodinámicas, cardiovasculares e infecciosas. En esta revisión, exponemos la alta prevalencia de esta enfermedad pulmonar en los principales padecimientos reumatológicos, con énfasis en la utilidad del ultrasonido pulmonar, su facilidad de realización y alto desempeño diagnóstico. (AU)

Patients with diffuse connective tissue diseases frequently develop interstitial lung disease, which carries a worse prognosis and shortens survival. High-resolution computed tomography is the first-choice test, and is competitive with histopathology, however, the cost and radiation may limit its use, particularly for screening. Lung ultrasound is a rapid, accessible, reproducible, and inexpensive study that is useful for diagnosis of interstitial lung disease. Furthermore, extensive training is not required to identify the alterations associated with these lung diseases. B lines and pleural irregularities compose the ultrasonographic interstitial syndrome, although it must be kept in mind that it is not specific, and it is necessary to rule out haemodynamic, cardiovascular, and infectious abnormalities. This review highlights the elevated prevalence of this lung condition in the main rheumatological diseases, with emphasis on the usefulness of pulmonary ultrasound. (AU)

Ultrasound for diagnosis of interstitial lung disease in diffuse connective tissue diseases.

Patients with diffuse connective tissue diseases frequently develop interstitial lung disease, which carries a worse prognosis and shortens survival. High-resolution computed tomography is the first-choice test, and is competitive with histopathology, however, the cost and radiation may limit its use, particularly for screening. Lung ultrasound is a rapid, accessible, reproducible, and inexpensive study that is useful for diagnosis of interstitial lung disease. Furthermore, extensive training is not required to identify the alterations associated with these lung diseases. B lines and pleural irregularities compose the ultrasonographic interstitial syndrome, although, it must be kept in mind that it is not specific, and it is necessary to rule out haemodynamic, cardiovascular, and infectious abnormalities. This review highlights the elevated prevalence of this lung condition in the main rheumatological diseases, with emphasis on the usefulness of pulmonary ultrasound.