Can High Frequency Transthoracic Sonography Play a Competition Role with High Resolution Computed Tomography in Assessment of Dyspnea?

Abstract

The aim of the study was to assess the significance and diagnostic concert of pleural line aberrations and B-lines detected by high-resolution transthoracic sonography (TS) in contradiction of the high resolution computed tomography (HRCT) findings. The pleural lines and accompanying B-line were assessed using a linear transducer. The TS findings were assessed against the corresponding HRCT findings in the same location, which were considered to be the gold standard. Among 320 patients, pleural line changes were detected in 240 patients (75%) on TS. The characteristic variations of the pleural line were categorized into four types: slightly rough pleural line with confluent B-lines on TS corresponded with HRCT findings of ground-glass opacity; irregular and interrupted pleural line with confluent B-lines corresponded with parenchymal infiltration; fringed pleural line with confluent B-lines corresponded with superimposed ground-glass and irregular reticular opacities; and fringed pleural line with scattered B-lines corresponded with irregularly thickened interlobular septa. Wavy pleural line indicated subpleural emphysema. The coexistence of more than one abnormal pleural line was also found in in 96 cases (30%). In conclusion, High-frequency TS may help in the early assessment of lung pathology by its ability to recognize pleural line anomalies and B-lines that are shown to be associated with CT changes, which could add diagnostic value in the emergency assessment of dyspneic patients.