Abstract
Lung ultrasonography (LUS) provides an estimation of peripheral airspace (PAS) geometry of the lung. Altered PAS produces sonographic interstitial syndrome (SIS). Idiopathic pulmonary fibrosis (IPF) involves peripheral lung with altered PAS. The aim of the study is to correlate echographic patterns with peripheral fibrotic changes on high-resolution Chest CT scan (HRCT). Patients underwent LUS and HRCT on the same date. Four LUS patterns were described: (1) near normal; (2) SIS with predominance of reverberant artifacts; (3) SIS with vertical predominance; (4) white lung. Four HRCT grades of peripheral fibrotic infiltrates were reported: grade 1 mild; grade 2 moderate; grade 3 severe; grade 4 massive or honeycomb. LUS pattern 1 was indicative of mild to moderate fibrotic alterations in 100% of cases. LUS pattern 2 matched with HRCT grade 2 in 24 out of 30 cases (77%). Huge discordance in four cases because of large honeycomb cysts. LUS pattern 3 was indicative of severe to massive alterations in 100% of cases. LUS pattern 4 showed a heterogeneous distribution of HRCT grades, severe changes, and ground glass opacities (GGO). This preliminary work demonstrates some level of agreement between LUS patterns and HRCT grades. Limitations and methodological issues have been shown to support subsequent studies of agreement.
Highlights
Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of idiopathic interstitial pneumonia with an extremely poor prognosis
All the subjects included in this study had been already discussed and diagnosed as “Idiopathic pulmonary Fibrosis” (IPF) by a multidisciplinary team
Lung ultrasonography (LUS) pattern 1 was reported in 25 scans out of 84: 21 cases corresponded to grade 1 high-resolution Chest CT scan (HRCT) and four cases to grade 2 HRCT
Summary
Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of idiopathic interstitial pneumonia with an extremely poor prognosis. It is defined as a specific form of chronic, progressive, Appl. Sci. 2020, 10, 1617 irreversible fibrosing interstitial pneumonia of unknown cause with an unpredictable and variable clinical course [1,2,3]. Diagnosis of IPF is crucial for predicting prognosis and optimizing management, including the initiation of therapies [4]. An ever-growing interest for early diagnostic approaches is developing in order to get the correct diagnosis in a very early stage. The earlier is the suspected diagnosis, the earlier IPF patients can be followed with the most correct management process
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