Skip to main content
The Egyptian Journal of Bronchology
Download PDF

Fayoum experience in the ultrasonographic evaluation of diffuse parenchymal lung disease

Egyptian Journal of Bronchology volume 13, pages 204–213 (2019)Cite this article

Abstract

Objective

Chest ultrasound has many uses, both diagnostic and interventional. It may be used for the diagnosis of multiple pleural diseases (pleural effusion, pleural masses, and pneumothorax). It is also used in the diagnosis of diseases caused by lung parenchymal lesions, such as neoplasms, pulmonary embolism, pneumonia, and lung abscesses.

Aim

This study aimed to evaluate the sonographic features of diffuse parenchymal lung disease (DPLD).

Design

This was a prospective study.

Setting

The study was carried out at Fayoum University Hospital in Egypt during the period spanning from January 2017 to June 2017.

Patients and methods

This study included 120 participants. Sixty of them were diagnosed as having DPLD. For the diagnosis of these cases, we need a full medical history, a detailed clinical examination, spirometry, 6 min walk test, arterial blood gases’ analysis, high-resolution computed tomography, and chest ultrasound. The other 60 were studied as controls.

Statistical analysis

The data were collected and coded to facilitate data manipulation, and they were double entered into Microsoft Access; the data analysis was performed by using SPSS software, version 18 in Windows 7.

The simple descriptive analysis was carried out in the form of numbers and percentages for qualitative data and arithmetic means as central tendency measurement, SDs as measure of dispersion for the quantitative parametric data and the inferential statistic test.

Results

There was a female predominance with a wide range of age. Most of the cases were nonsmokers, breeding birds, and exposed to biomass. All cases had diffuse bilateral B-lines. There was a negative relation between the Warrick score on the one hand and the B-line number, PaO2, 6 min walk test, and forced vital capacity on the other hand.

In contrast, a positive relation was demonstrated between the Warrick score and B-line distance and pleural thickness. Most of the studied patients (71.6%) had irregular and thickened pleura and (51.6%) had an abolished lung sliding.

Conclusion

Chest ultrasound has a significant role in the diagnosis of DPLD and also in estimating the severity of the disease according to the number and the distance between B-lines.

Multiple B-lines in the combination of thickened and irregular pleural line are highly suggestive of DPLD.

References

  1. Gomez AD, King TE Jr. Classification of diffuse parenchymal lung disease:in diffuse parenchymal lung disease. Prog Respir Res Basel, Karger 2007; 36:2–10.

    Google Scholar 

  2. American Thoracic Society/European Respiratory Society. International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2002; 165:277–304.

    Article  Google Scholar 

  3. Stephens NJ, Pilcher JM. The diagnostic role of ultrasound in the chest. Ultrasound J 2007; 15:148–158.

    Article  Google Scholar 

  4. Saha K. Review article. Interstitial lung disease:diagnostic approach. J Assoc Chest Physicians 2014; 2:3–15.

    Article  Google Scholar 

  5. Copetti R, Soldati G, Copetti P. Chest sonography. a useful tool to differentiate acute cardiogenic pulmonary edema from acute respiratory distress syndrome. Cardiovasc Ultrasound 2008; 6:16.

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  7. Nici L, ZuWallack R. An official American Thoracic Society Workshop Report:the integrated care of the COPD patient. Proc Am Thorac Soc 2012; 9:9–18.

    Article  Google Scholar 

  8. American Association for Respiratory Care. Clinical practice guideline:exercise test for evaluation of hypoxemia and/or desaturation. Respir Care 2001; 46:514–522.

    Google Scholar 

  9. Warrick JH, Bhalla M, Schabel SI, Silver RM. High resolution computed tomography in early scleroderma lung disease. J Rheumatol 1991; 18:1520–1528.

    CAS  PubMed  Google Scholar 

  10. 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. 22–33.

    Book  Google Scholar 

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

    Article  CAS  Google Scholar 

  12. Volpicelli G, Elbarbary M, Blaivas M. International evidence-based recommendations for point of care lung ultrasound. Intensive Care Med 2012; 38:577–591.

    Article  Google Scholar 

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

    Article  Google Scholar 

  14. Piette E, Daoust R, Denault A. Basic concepts in the use of thoracic and lung ultrasound. Curr Opin Anaesthesiol 2013; 26:20–30.

    Article  Google Scholar 

  15. Soldati G, Copetti R, Sher S. Sonographic interstitial syndrome. The sound of lung water. J Ultrasound Med 2009; 28:163–74.

    Article  Google Scholar 

  16. Mohammadi A, Oshnoei S, Ghasemi-Rad M. Comparison of a new modified lung ultrasonography technique with high- resolution CT in the diagnosis of the alveolo-interstitial syndrome of systemic scleroderma. Med Ultrasound 2014; 16: 27–31.

    Google Scholar 

  17. Hasan A, Makhlouf H. B-lines:trans thoracic chest ultrasound signs useful in assessment of interstitial lung diseases. Ann Thorac Med 2014; 9:99–103.

    Article  Google Scholar 

  18. Farag T, Adawy Z, Sakb L. Transthoracic ultrasonographic features of diffuse parenchymal lung diseases. Egypt J Bronchol 2017; 11:179–187.

    Article  Google Scholar 

  19. Agmy G, Sayed S, Said A, Kasem A. Assessment of transthoracic sonography in patients with interstitial lung diseases. Egypt J Bronchol 2016; 10:105–112.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Chest Diseases and Tuberculosis, Faculty of Medicine, Fayoum University, 63514, Egypt

    Sherif Refaat Abd ElvFatah (Professor)

  2. Chest Diseases and Tuberculosis, Faculty of Medicine, Fayoum University, Egypt

    Radwa Ahmed Elhefny (Associate Professor)

  3. Chest Diseases and Tuberculosis, Faculty of Medicine, Fayoum University, Egypt

    Randa Ibrahim Ahmed (Lecturer)

  4. Resident of Chest diseases and Tuberculosis in Fayoum Chest Hospital, Egypt

    Doaa Mohamed Abd ElTawab

Authors
  1. Sherif Refaat Abd ElvFatah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Radwa Ahmed Elhefny
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Randa Ibrahim Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Doaa Mohamed Abd ElTawab
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sherif Refaat Abd ElvFatah.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given 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

Abd ElvFatah, S.R., Elhefny, R.A., Ahmed, R.I. et al. Fayoum experience in the ultrasonographic evaluation of diffuse parenchymal lung disease. Egypt J Bronchol 13, 204–213 (2019). https://doi.org/10.4103/ejb.ejb_54_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejb.ejb_54_18

Keywords