The Role of Transthoracic Ultrasound in the Study of Interstitial Lung Diseases: High-Resolution Computed Tomography Versus Ultrasound Patterns: Our Preliminary Experience.

Donato Lacedonia,Giulia Scioscia,Carla Maria Irene Quarato,Maria Pia Foschino Barbaro,Marco Sperandeo,Angelamaria Giardinelli,Ennio Vincenzo Sassani,Federica Maci

doi:10.3390/diagnostics11030439

Abstract

Transthoracic ultrasound (TUS) is a readily available imaging tool that can provide a quick real-time evaluation. The aim of this preliminary study was to establish a complementary role for this imaging method in the approach of interstitial lung diseases (ILDs). TUS examination was performed in 43 consecutive patients with pulmonary fibrosis and TUS findings were compared with the corresponding high-resolution computed tomography (HRCT) scans. All patients showed a thickened hyperechoic pleural line, despite no difference between dominant HRCT patterns (ground glass, honeycombing, mixed pattern) being recorded (p > 0.05). However, pleural lines’ thickening showed a significant difference between different HRCT degree of fibrosis (p < 0.001) and a negative correlation with functional parameters. The presence of >3 B-lines and subpleural nodules was also assessed in a large number of patients, although they did not demonstrate any particular association with a specific HRCT finding or fibrotic degree. Results allow us to suggest a complementary role for TUS in facilitating an early diagnosis of ILD or helping to detect a possible disease progression or eventual complications during routine clinical practice (with pleural line measurements and subpleural nodules), although HRCT remains the gold standard in the definition of ILD pattern, disease extent and follow-up.

Highlights

Interstitial lung diseases (ILDs) are a heterogeneous group of lung diseases characterized by an abnormal and progressive scarring reaction of the interstitium, resulting in impaired gas exchange and in a restrictive alteration
Current international guidelines recommend that, for each patient suspected of having an ILD, a multidisciplinary conference in a dedicated Lung Unit should take place to discuss clinical, functional and high-resolution computed tomography (HRCT) findings for diagnostic and therapeutic decision-making [3,4]
Results of our preliminary study showed that HRCT patterns produce similar, more or less recognizable, ultrasound artifacts

Summary

Introduction

Interstitial lung diseases (ILDs) are a heterogeneous group of lung diseases characterized by an abnormal and progressive scarring reaction of the interstitium, resulting in impaired gas exchange and in a restrictive (spirometric) alteration. Their etiology can be of a primitive nature or secondary (e.g., connective diseases, hypersensitivity and drug toxicity). Current international guidelines recommend that, for each patient suspected of having an ILD, a multidisciplinary conference in a dedicated Lung Unit should take place to discuss clinical, functional and high-resolution computed tomography (HRCT) findings for diagnostic and therapeutic decision-making [3,4]. Lung function tests help in monitoring the progression and in determining the severity of disease

Methods

Discussion

Conclusion