Purpose To evaluate the utility of modified lung ultrasound (LUS) and quantitative computed tomography (QCT) in assessing connective tissue disease–associated interstitial lung disease (CTD-ILD) and their correlations with high-resolution computed tomography (HRCT) of the chest. Methods Between October 2023 and 2024, 77 hospitalized CTD patients (57 CTD-ILD, 20 controls) who had undergone or were scheduled for chest HRCT also received LUS during their hospitalization, ensuring both assessments were completed within 1 week. The LUS and HRCT results were evaluated using modified LUS scores and Warrick scores, respectively. HRCT results were analyzed quantitatively using the “Dexin-FACT” automated analysis software. Results Significant differences were observed in all LUS parameters and most QCT parameters between groups (P < 0.01), with significant correlations to ILD severity stratification (P < 0.05). Univariate analysis identified modified LUS scores, LAA-600~-250%, and the TAV/TNV ratio (the ratio of lumen area to number of blood vessels around the bronchus with a 2 mm diameter in the lower lobe of the lung) as being associated with ILD (P < 0.01). After initial adjustment for age, gender, and BMI, the modified LUS scores demonstrated a significant association with CTD-ILD (OR = 1.94, 95% CI 1.26–2.98). Notably, this association was substantially strengthened in the fully adjusted model controlling for a broader set of clinical confounders, including smoking, disease duration, complications, and CTD type (aOR = 3.62, 95% CI 1.58–8.29), confirming it as the strongest independent predictor compared to LAA-600~-250% and TAV/TNV. The modified LUS scores showed excellent diagnostic concordance with the Warrick scores (AUC = 0.960), outperforming LAA-600~-250% (AUC = 0.873). Conclusion Modified LUS shows potential as a practical tool for CTD-ILD detection, outperforming QCT parameters in diagnostic agreement with HRCT. These preliminary findings support LUS as an effective adjunct for CTD-ILD assessment. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Modified lung ultrasound scores outperformed traditional ultrasound metrics in distinguishing connective tissue disease–associated interstitial lung disease severity and showed the strongest predictive association with disease presence. • Significant differences in lung ultrasound and quantitative CT parameters were observed between connective tissue disease–associated interstitial lung disease and non-interstitial lung disease groups, correlating with disease progression and severity stratification. • Modified lung ultrasound demonstrated superior specificity to quantitative CT in detecting connective tissue disease–associated interstitial lung disease, highlighting its potential as a practical, non-invasive adjunct to HRCT. </entry> </row> </tbody> </tgroup> </Table>

Diagnostic value of lung ultrasound vs. quantitative computed tomography in connective tissue disease–associated interstitial lung disease: a preliminary study

期刊论文
发表日期：

2026年1月15日

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Xiaokun Xin,
Meng Huang,
Hui Yuan,
Li Zhang,
Shan Dang,
Guoqin Huang,
Nan Yu

摘要

Purpose

To evaluate the utility of modified lung ultrasound (LUS) and quantitative computed tomography (QCT) in assessing connective tissue disease–associated interstitial lung disease (CTD-ILD) and their correlations with high-resolution computed tomography (HRCT) of the chest.

Methods

Between October 2023 and 2024, 77 hospitalized CTD patients (57 CTD-ILD, 20 controls) who had undergone or were scheduled for chest HRCT also received LUS during their hospitalization, ensuring both assessments were completed within 1 week. The LUS and HRCT results were evaluated using modified LUS scores and Warrick scores, respectively. HRCT results were analyzed quantitatively using the “Dexin-FACT” automated analysis software.

Results

Significant differences were observed in all LUS parameters and most QCT parameters between groups (P < 0.01), with significant correlations to ILD severity stratification (P < 0.05). Univariate analysis identified modified LUS scores, LAA_-600~-250%, and the TAV/TNV ratio (the ratio of lumen area to number of blood vessels around the bronchus with a 2 mm diameter in the lower lobe of the lung) as being associated with ILD (P < 0.01). After initial adjustment for age, gender, and BMI, the modified LUS scores demonstrated a significant association with CTD-ILD (OR = 1.94, 95% CI 1.26–2.98). Notably, this association was substantially strengthened in the fully adjusted model controlling for a broader set of clinical confounders, including smoking, disease duration, complications, and CTD type (aOR = 3.62, 95% CI 1.58–8.29), confirming it as the strongest independent predictor compared to LAA_-600~-250% and TAV/TNV. The modified LUS scores showed excellent diagnostic concordance with the Warrick scores (AUC = 0.960), outperforming LAA_-600~-250% (AUC = 0.873).

Conclusion

Modified LUS shows potential as a practical tool for CTD-ILD detection, outperforming QCT parameters in diagnostic agreement with HRCT. These preliminary findings support LUS as an effective adjunct for CTD-ILD assessment.

Key Points

• Modified lung ultrasound scores outperformed traditional ultrasound metrics in distinguishing connective tissue disease–associated interstitial lung disease severity and showed the strongest predictive association with disease presence.

• Significant differences in lung ultrasound and quantitative CT parameters were observed between connective tissue disease–associated interstitial lung disease and non-interstitial lung disease groups, correlating with disease progression and severity stratification.

• Modified lung ultrasound demonstrated superior specificity to quantitative CT in detecting connective tissue disease–associated interstitial lung disease, highlighting its potential as a practical, non-invasive adjunct to HRCT.