Transthoracic ultrasonographic features of diffuse parenchymal lung diseases

Taghreed S Farag, Zeinab R Adawy, Lobna K Sakr, Hanaa S Abdellateef

Egyptian Journal of Bronchology 2017 11(3):179-187

Objectives The value of transthoracic ultrasonography (TTUS) in diffuse parenchymal lung disease (DPLD) has not been established yet. This prospective study was conducted to assess pleural and parenchymal alterations in patients with DPLD by TTUS and to compare the results with chest high-resolution computed tomography (HRCT). The results of TTUS were compared with some arterial blood gas (ABG) parameters and 6-min walk test (6MWT). Patients and methods This study was conducted on 50 patients. All patients underwent HRCT, resting ABGs, and 6MWT, in addition to TTUS to evaluate (a) the presence and number of B-line and distance between them, (b) pleural effusion, (c) pleural thickening, (d) an irregular, fragmented pleural line, and (e) subpleural alterations. Results The studied group showed female predominance, wide range of age, and most of them were nonsmokers. All patients had diffuse bilateral B-lines. B-line numbers were inversely correlated with severity of pulmonary fibrosis detected by HRCT modified Warrick score; however, distance between B-lines was directly correlated with severity of pulmonary fibrosis. Some ABGs (resting PaO2, resting SpO2%, AaDO2) and 6MWT parameters were correlated with B-line number and distance between them. As detected by TTUS, the majority of patients (82%) had irregular thickened pleural line, whereas 44% of them had absent lung sliding. Conclusion TTUS can play a complementary role in the diagnosis and monitoring of DPLD patients. Multiple B-lines distributed over the entire lung surface in combination with a thickened, irregular, and fragmented pleural line are strongly suggestive of the presence of DPLD. TTUS gives an idea about diffuse or limited, early, or advanced DPLD.

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