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Rheumatology Advance Access originally published online on August 28, 2009
Rheumatology 2009 48(11):1382-1387; doi:10.1093/rheumatology/kep263
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis

Luna Gargani1, Marica Doveri2, Luigia D’Errico3, Francesca Frassi1, Maria L. Bazzichi2, Andrea Delle Sedie2, Maria C. Scali4, Simonetta Monti1, Sergio Mondillo4, Stefano Bombardieri2, Davide Caramella3 and Eugenio Picano1

1Institute of Clinical Physiology, National Research Council, 2Department of Internal Medicine, 3Diagnostic and Interventional Radiology, University of Pisa, Pisa and 4Department of Cardiology, University of Siena, Siena, Italy.

Correspondence to: Luna Gargani, Institute of Clinical Physiology, National Research Council, Via G. Moruzzi, 1, 56124, Pisa, Italy. E-mail: gargani{at}ifc.cnr.it


  Abstract

Objective. To assess the correlation between ultrasound lung comets (ULCs, a recently described echographic sign of interstitial lung fibrosis) and the current undisputed gold-standard high-resolution CT (HRCT) to detect pulmonary fibrosis in patients with SSc.

Methods. We enrolled 33 consecutive SSc patients (mean age 54 ± 13 years, 30 females) in the Rheumatology Clinic of the University of Pisa. We assessed ULCs and chest HRCT within 1 week independently in all the patients. ULC score was obtained by summing the number of lung comets on the anterior and posterior chest. Pulmonary fibrosis was quantified by HRCT with a previously described 30-point Warrick score.

Results. Presence of ULCs (defined as a total number more than 10) was observed in 17 (51%) SSc patients. Mean ULC score was 37 ± 50, higher in the diffuse than in the limited form (73 ± 66 vs 21 ± 35; P < 0.05). A significant positive linear correlation was found between ULCs and Warrick scores (r = 0.72; P < 0.001).

Conclusions. ULCs are often found in SSc, are more frequent in the diffuse than the limited form and are reasonably well correlated with HRCT-derived assessment of lung fibrosis. They represent a simple, bedside, radiation-free hallmark of pulmonary fibrosis of potential diagnostic and prognostic value.

KEY WORDS: Chest sonography, High-resolution computed tomography, Ultrasound lung comets, Systemic sclerosis

Submitted 3 November 2008; revised version accepted 23 July 2009.
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