The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis
| Autor: | Daniel Traila, Lavinia Davidescu, Voicu Tudorache, Diana Manolescu, Cristian Oancea |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Scars Lung biopsy Review chest ultrasound 03 medical and health sciences Idiopathic pulmonary fibrosis 0302 clinical medicine Usual interstitial pneumonia Fibrosis Pulmonary fibrosis medicine interstitial lung diseases Humans Idiopathic interstitial pneumonia Ultrasonography 030203 arthritis & rheumatology Lung business.industry chest high-resolution computed tomography Reproducibility of Results General Medicine respiratory system medicine.disease interstitial syndrome Idiopathic Pulmonary Fibrosis respiratory tract diseases medicine.anatomical_structure 030228 respiratory system Disease Progression Radiology Geriatrics and Gerontology medicine.symptom business Tomography X-Ray Computed B-lines artifacts |
| Zdroj: | Clinical Interventions in Aging |
| ISSN: | 1178-1998 1176-9092 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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