Transthoracic Ultrasound Elastography in Pulmonary Lesions and Diseases

Abstract

Ultrasound elastography has shown promising result in the diagnosis of various diseases, however, its application in pulmonary diseases has yet to be elucidated. Our study aimed to assess the application and feasibility of ultrasound elastography in various pulmonary lesions and diseases. We enrolled forty-five patients with radiographic evidence of pneumonia, tumors or obstructive pneumonitis and 70 ultrasonic lesions were identified (eight necrosis, 17 atelectasis, seven consolidation and 38 tumors). Ultrasound elastography was performed and the strain ratio, which was the ratio of strain of the reference tissue to an equally measuring region of interest of a lesion, was measured. The strain ratio was significantly different between these lesions with different ultrasound morphology (necrosis vs. atelectasis vs. consolidation vs. tumor: 1.03 ± 0.71 vs. 2.51 ± 1.14 vs. 19.98 ± 15.59 vs. 36.19 ± 20.18; p<0.05). The strain ratio of primary lung cancer was also significantly different from pneumonia (p=0.023) and metastatic lung cancer (p=0.015). From the result of our study, we concluded that transthoracic ultrasound elastography can differentiate pulmonary lesions with different ultrasound morphology. In addition to B-mode ultrasound, this newly emerges ultrasound mode can be applied in invasive ultrasound-guided procedures, such as ultrasound-guided aspiration and biopsy.