Twelve lung zones protocol of ultrasound mapping in idiopathic pulmonary fibrosis

Abstract

Introduction: Multiple B-lines represents the hallmark of interstitial syndrome on lung ultrasound (LUS) evaluation. The role of LUS is currently under investigation when patients with IPF are examined as a single group. We compare the lung changes of IPF using a LUS protocol of 12 zones with “current standard” high resolution computed tomography (HRCT) diagnostic method and overlap it with the functional pulmonary test (PFT). Methods: The diagnosis of IPF was established by a multidisciplinary team based on the current international criteria. 31 patients were included in the study and performed HRCT, lung ultrasound and PFT. A 12-lung zones LUS protocol was used and compared with HRCT and PFT. This protocol was chosen for an equal assessment of anterior, lateral and posterior lung zones in both sides. Results: To assess the prediction possibility of IPF severity based on the pleura’s thickness we built a receiver-operating characteristics model having the predictor variable the pleura’s thickness and outcome the diagnosis of moderate or severe fibrosis. The model proved that pleura’s thickness may be a valid predictor for severe or moderate fibrosis (area under ROC curve = 0.943; p Conclusion: B-lines and the average thickness of pleural line as LUS markers of fibrotic interstitial syndrome are highly and positively correlated with HRCT score, FVC and DLCO.