The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis

Diana Manolescu,1 Lavinia Davidescu,2 Daniel Traila,3 Cristian Oancea,3 Voicu Tudorache3 1Radiology Department, University of Medicine and Pharmacy “Victor Babes”, Timişoara, Romania; 2Department of Pulmonology, University of Medicine and Pharmacy Oradea, Oradea, Romania; 3Depar...

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Autores principales:	Manolescu D, Davidescu Lavinia, Traila D, Oancea C, Tudorache V
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Lung ultrasound chest high resolution computed tomography B lines artifacts interstitial syndrome idiopathic pulmonary fibrosis Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/0f75513b3958408a9a5c057ad2970908
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spelling	oai:doaj.org-article:0f75513b3958408a9a5c057ad29709082021-12-02T02:31:34ZThe reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis1178-1998https://doaj.org/article/0f75513b3958408a9a5c057ad29709082018-03-01T00:00:00Zhttps://www.dovepress.com/the-reliability-of-lung-ultrasound-in-assessment-of-idiopathic-pulmona-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Diana Manolescu,1 Lavinia Davidescu,2 Daniel Traila,3 Cristian Oancea,3 Voicu Tudorache3 1Radiology Department, University of Medicine and Pharmacy “Victor Babes”, Timişoara, Romania; 2Department of Pulmonology, University of Medicine and Pharmacy Oradea, Oradea, Romania; 3Department of Pulmonology, University of Medicine and Pharmacy “Victor Babes”, Timişoara, Romania Abstract: Idiopathic pulmonary fibrosis (IPF) is the severest form of idiopathic interstitial pneumonia, with a median survival time estimated at 2–5 years from the time of diagnosis. It occurs mainly in elderly adults, suggesting a strong link between the fibrosis process and aging. Although chest high-resolution computed tomography (HRCT) is currently the method of choice in IPF assessment, diagnostic imaging with typical usual interstitial pneumonia (UIP) provides definitive results in only 55%, requiring an invasive surgical procedure such as lung biopsy or cryobiopsy for the final diagnostic analysis. Lung ultrasound (LUS) as a noninvasive, non-radiating examination is very sensitive to detect subtle changes in the subpleural space. The evidence of diffuse, multiple B-lines defined as vertical, hyperechoic artifacts is the hallmark of interstitial syndrome. A thick, irregular, fragmented pleura line is associated with subpleural fibrotic scars. The total numbers of B-lines are correlated with the extension of pulmonary fibrosis on HRCT, being an LUS marker of severity. The average distance between two adjacent B-lines is an indicator of a particular pattern on HRCT. It is used to appreciate a pure reticular fibrotic pattern as in IPF compared with a predominant ground glass pattern seen in fibrotic nonspecific interstitial pattern. The distribution of the LUS artifacts has a diagnostic value. An upper predominance of multiple B-lines associated with the thickening of pleura line is an LUS feature of an inconsistent UIP pattern, excluding the IPF diagnosis. LUS is a repeatable, totally radiation-free procedure, well tolerated by patients, very sensitive in detecting early changes of fibrotic lung, and therefore a useful imaging technique in monitoring disease progression in the natural course or after initiation of treatment. Keywords: chest ultrasound, chest high-resolution computed tomography, B-lines artifacts, interstitial syndrome, interstitial lung diseasesManolescu DDavidescu LaviniaTraila DOancea CTudorache VDove Medical PressarticleLung ultrasoundchest high resolution computed tomographyB lines artifactsinterstitial syndromeidiopathic pulmonary fibrosisGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 13, Pp 437-449 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lung ultrasound chest high resolution computed tomography B lines artifacts interstitial syndrome idiopathic pulmonary fibrosis Geriatrics RC952-954.6
spellingShingle	Lung ultrasound chest high resolution computed tomography B lines artifacts interstitial syndrome idiopathic pulmonary fibrosis Geriatrics RC952-954.6 Manolescu D Davidescu Lavinia Traila D Oancea C Tudorache V The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
description	Diana Manolescu,1 Lavinia Davidescu,2 Daniel Traila,3 Cristian Oancea,3 Voicu Tudorache3 1Radiology Department, University of Medicine and Pharmacy “Victor Babes”, Timişoara, Romania; 2Department of Pulmonology, University of Medicine and Pharmacy Oradea, Oradea, Romania; 3Department of Pulmonology, University of Medicine and Pharmacy “Victor Babes”, Timişoara, Romania Abstract: Idiopathic pulmonary fibrosis (IPF) is the severest form of idiopathic interstitial pneumonia, with a median survival time estimated at 2–5 years from the time of diagnosis. It occurs mainly in elderly adults, suggesting a strong link between the fibrosis process and aging. Although chest high-resolution computed tomography (HRCT) is currently the method of choice in IPF assessment, diagnostic imaging with typical usual interstitial pneumonia (UIP) provides definitive results in only 55%, requiring an invasive surgical procedure such as lung biopsy or cryobiopsy for the final diagnostic analysis. Lung ultrasound (LUS) as a noninvasive, non-radiating examination is very sensitive to detect subtle changes in the subpleural space. The evidence of diffuse, multiple B-lines defined as vertical, hyperechoic artifacts is the hallmark of interstitial syndrome. A thick, irregular, fragmented pleura line is associated with subpleural fibrotic scars. The total numbers of B-lines are correlated with the extension of pulmonary fibrosis on HRCT, being an LUS marker of severity. The average distance between two adjacent B-lines is an indicator of a particular pattern on HRCT. It is used to appreciate a pure reticular fibrotic pattern as in IPF compared with a predominant ground glass pattern seen in fibrotic nonspecific interstitial pattern. The distribution of the LUS artifacts has a diagnostic value. An upper predominance of multiple B-lines associated with the thickening of pleura line is an LUS feature of an inconsistent UIP pattern, excluding the IPF diagnosis. LUS is a repeatable, totally radiation-free procedure, well tolerated by patients, very sensitive in detecting early changes of fibrotic lung, and therefore a useful imaging technique in monitoring disease progression in the natural course or after initiation of treatment. Keywords: chest ultrasound, chest high-resolution computed tomography, B-lines artifacts, interstitial syndrome, interstitial lung diseases
format	article
author	Manolescu D Davidescu Lavinia Traila D Oancea C Tudorache V
author_facet	Manolescu D Davidescu Lavinia Traila D Oancea C Tudorache V
author_sort	Manolescu D
title	The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
title_short	The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
title_full	The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
title_fullStr	The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
title_full_unstemmed	The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
title_sort	reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/0f75513b3958408a9a5c057ad2970908
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The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis

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