A COMPARATIVE ANALYSIS OF CHEST ULTRASONOGRAPHY AND HIGHRESOLUTION CT IN THE DIAGNOSIS AND EVALUATION OF INTERSTITIAL LUNG DISEASES

Abstract

Background: Recent findings indicate the potential utility of lung ultrasound (LUS) in
detecting interstitial lung disease (ILD) through the assessment of B-lines, a sonographic
indicator of pulmonary interstitial syndrome. However, there is a lack of prospective studies
comparing LUS to chest X-ray (CXR) for ILD evaluation. Additionally, consensus on specific
echographic diagnostic criteria for defining ILD remains elusive. The current study aimed to
determine the role of transthoracic LUS in diagnosing and assessing ILD and to correlate its
findings with HRCT.
Methods: A total of 40 Patients with interstitial lung disease (ILD), meeting clinical,
laboratory, or radiological criteria and consenting to participate, were enrolled in the current
study. Clinical evaluations, including history, physical examination, and a questionnaire
covering personal data, medical history, environmental and drug exposure, and symptoms
(Borg test dyspnea score and Borg test for pre- and post-effort fatigue), were conducted.
Participants underwent chest ultrasound and high-resolution computed tomography (HRCT),
categorized by Warrick's score into mild, moderate, and severe ILD groups.
Results: Chest ultrasound revealed a total B-lines score of 71.24 ± 31.25 and the mean positive
chest areas score of 6.69 ± 2.62. Concurrently, significant HRCT findings indicated that
ground-glass opacification (GGO) was observed in 20 (50%) patients, and a reticulonodular
interstitial pattern (RNP) was observed in 15 (37.5%) patients. There is an increased prevalence
of cases exhibiting elevated B-lines scores in the lower lung areas (Area 3 and Area 4) in
comparison to the upper lung areas (Area 1 and Area 2). The correlation between Warrick score and B-lines distance with a coefficient of -0.910, indicates a strong negative correlation.
Conclusion: In conclusion, while no imaging modalities can fully replace the comprehensive
information provided by chest HRCT, which remains the gold standard for assessing
pulmonary fibrosis, LUS in ILD presents itself as a useful, cost-effective, accessible, and
radiation-free investigative tool.