Skip to main content
The Egyptian Journal of Bronchology
Download PDF

Assessment of transthoracic sonography in patients with interstitial lung diseases

Egyptian Journal of Bronchology volume 10, pages 105–112 (2016)Cite this article

Abstract

Aim

This study was designed to recognize the sonographic features of interstitial lung diseases (ILD). Furthermore, the possible correlations of these features with the functional and radiological parameters of the disease were assessed.

Patients and methods

Forty-two patients with ILD were included; each patient underwent spirometry, Multi Detector CT chest (MDCT) and transthoracic sonography (TS). Fifteen healthy volunteers were also studied as controls.

Results

The sonographic features among ILD patients were B lines in 73.8% , abolished lung sliding in 23.8%, irregular and thickened pleura in 47.6%and 35.7% respectively and subpleural lesions in 38.1%.Increasing distance between the B lines was negatively correlated with both of Forced Vital Capacity % predicted , ground glass opacities and positively correlated with reticular opacities patterns on MDCT chest.

Conclusion

TS can be used as an additional imaging method for assessment of ILD and as a marker to estimate the severity of disease.

References

  1. Havelock T, Teoh R, Laws D, Gleeson F. Pleural procedures and thoracic ultrasound: British Thoracic Society Guidelines, Pleural Diseases. Thorax 2010;659:ii72–ii74.

  2. Deconinck B, Verschakelen J, Coolen J, Verbeken E, Verleden G, Wuyts W. Diagnostic workup for diffuse parenchymal lung disease: schematic flowchart, literature review, and pitfalls. Lung 2013;191(1):19–25.

    Article  Google Scholar 

  3. American Thoracic Society; European Respiratory Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 2002;165(2):277–304.

    Article  Google Scholar 

  4. Reissig A, Kroegel C. Transthoracic sonography of diffuse parenchymal lung disease: the role of comet tail artifacts. J Ultrasound Med 2003;22 (2):173–180.

    Article  Google Scholar 

  5. Barskova T, Gargani L, Guiducci S, Randone SB, Bruni C, Carnesecchi G et al. Lung ultrasound for the screening of interstitial lung disease in very early systemic sclerosis. Ann Rheum Dis 2013;72(3):390–395.

    Article  Google Scholar 

  6. Buzan MT, Pop CM. State of the art in the diagnosis and management of interstitial lung disease. Clujul Med 2015;88(2):116–123.

    PubMed  PubMed Central  Google Scholar 

  7. Aaron SD, Dales RE, Cardinal P. How accurate is spiromety at predicting restrictive pulmonary impairment? Chest 1999;115:869–873.

    Article  CAS  Google Scholar 

  8. Raghu G, Collard HR, Egan J, Martinez FJ, Behr J, Brown KK et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fi brosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011;183:788–824.

    Article  Google Scholar 

  9. Selman M. Hypersensitivity pneumonitis: a multifaceted deceiving disorder. Clin Chest Med 2004;25(3):531–547.

    Article  Google Scholar 

  10. Kligerman SJ, Groshong S, Brown KK, Lynch DA. Nonspecific interstitial pneumonia: radiologic, clinical, and pathologic considerations. Radiographics 2009;29(1):73–87.

    Article  Google Scholar 

  11. Bolliger CT, Herth FJ, Mayo PH, Miyazawa T, Beamis JF (Eds). Clinical chest ultrasound: from the ICU to the bronchoscopy suite, Prog Respir Res. Switzerland: Karger Medical and Scientific Publishers; 2009; 37:22–33.

    Google Scholar 

  12. Lichtenstein D, Mezière G, Biderman P, Gepner A. The comet-tail artifact: an ultrasound sign ruling out pneumothorax. Intensive Care Med 1999;25 (4):383–388.

    Article  CAS  Google Scholar 

  13. Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest 2008;134(1):117–125.

    Article  Google Scholar 

  14. Lichtenstein DA. Suggestion for classifying air artifacts. Whole body ultrasonography in the critically ill. Berlin, Heidelberg, New York: Springer-Verlag; 2010: 185–188.

    Chapter  Google Scholar 

  15. Tsai TH, Yang PC. Ultrasound in the diagnosis and management of pleural disease. Curr Opin Pulm Med 2003;9(4): 282–290.

    Article  Google Scholar 

  16. Wu RG, Yuan A, Liaw YS, Chang DB, Yu CJ, Wu HD et al. Image comparison of real-time gray-scale ultrasound and color Doppler ultrasound for use in diagnosis of minimal pleural effusion. Am J Respir Crit Care Med 1994;150(2):510–514.

    Article  CAS  Google Scholar 

  17. Targhetta R, Chavagneux R, Balmes P, Lemerre C, Mauboussin JM, Bourgeois JM, Pourcelot L. Sonographic lung surface evaluation in pulmonary sarcoidosis: preliminary results. J Ultrasound Med 1994;13(5):381–388.

    Article  CAS  Google Scholar 

  18. Gargani L, Doveri M, D’Errico L, Frassi F, Bazzichi ML, Delle Sedie A et al. Ultrasound lung comets in systemic sclerosis: a chest sonography hallmark of pulmonary interstitial fibrosis. Rheumatology (Oxford) 2009;48(11):1382–1387.

    Article  Google Scholar 

  19. Picano E, Frassi F, Agricola E, Gligorova S, Gargani L, Mottola G. Ultrasound lung comets: a clinically useful sign of extravascular lung water. J Am Soc Echocardiography 2006;19:356–363.

    Article  Google Scholar 

  20. Agricola E, Bove T, Oppizzi M, Marino G, Zangrillo A, Margonato A, Picano E. Ultrasound comet-tail images’: a marker of pulmonary edema: a comparative study with wedge pressure and extravascular lung water. Chest 2005;127:1690–1695.

    Article  Google Scholar 

  21. Lichtenstein D, Mezière G, Biderman P, Gepner A, Barre O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997;156(5):1640–1646.

    Article  CAS  Google Scholar 

  22. Doveri M, Frassi F, Consensi A, Vesprini E, Gargani L, Tafuri M et al. Ultrasound lung comets: new echographic sign of lunginterstitial fibrosis in systemic sclerosis. Reumatismo 2008;60:180–184.

    CAS  PubMed  Google Scholar 

  23. Sperandeo M, Varriale A, Sperandeo G, Filabozzi P, Piattelli ML, Carnevale V et al. Transthoracic ultrasound in the evaluation of pulmonary fibrosis: our experience. Ultrasound Med Biol 2009;35 (5):723–729.

    Article  Google Scholar 

  24. Gryminski J, Krakowka P, Lypacewicz G. The diagnosis of pleural effusion by ultrasonic and radiological techniques. Chest 1976;70:33–37.

    Article  CAS  Google Scholar 

  25. Hasan A, Makhlouf H, Mohamed A. Discrimination between pleural thickening and minimal pleural effusion using color Doppler chest ultrasonography. Egypt J Chest Dis Tuberc 2013;62:429–433.

    Article  Google Scholar 

  26. Assayag D, Kaduri S, Hudson M, Hirsch A, Baron M. High resolution computed tomography scoring systems for evaluating interstitial lung disease in systemic sclerosis patients. Rheumatology 2012;51: ii3–ii5.

  27. Pinal-Fernandez I, Pallisa-Nuñez E, SelvaOCallaghan A, Castella-Fierro E, Simeon-Aznar CP, Fonollosa-Pla V, Vilardell-Tarres M. Pleural irregularity, a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome. Clin Exp Rheumatol 2015;33(4): Suppl 91:S136–S141.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Assiut University, Cairo, Egypt

    Suzan S. Sayed & Gamal M. Agmy

  2. Department of Chest Diseases, Faculty of Medicine, Minia University, Cairo, 6111, Egypt

    Azza F. Said (MD) & Ahmed H. Kasem

Authors
  1. Suzan S. Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gamal M. Agmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Azza F. Said
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmed H. Kasem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Azza F. Said.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sayed, S.S., Agmy, G.M., Said, A.F. et al. Assessment of transthoracic sonography in patients with interstitial lung diseases. Egypt J Bronchol 10, 105–112 (2016). https://doi.org/10.4103/1687-8426.184375

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1687-8426.184375

Keywords