Kumar Ishan, Siddiqui Zeeshan, Verma Ashish, Chokhani Aarushi, Srivastava Govind Narayan, Shukla Ram C
Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of TB and Respiratory Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Ann Thorac Med. 2021 Jan-Mar;16(1):110-117. doi: 10.4103/atm.ATM_145_20. Epub 2021 Jan 14.
Accurate staging of disease severity and its serial monitoring thus is central to the effective management protocols of interstitial lung disease (ILD).
The aim is to evaluate the effectiveness of semi-quantitative parameters of lung ultrasound (LUS) in patients of ILD as a means of staging disease severity.
LUS of 47 patients of ILD and 20 age-matched controls was performed, and findings such as B-line distance, pleural thickening, subpleural changes, decreased lung sliding, and fragmented pleural lining were charted, and an LUS score was done using these parameters. Findings were compared with the Modified Medical Research Council (MMRC) dyspnea grade and spirometry parameters.
The presence of B-lines and fragmented pleural lining were the most common findings observed in patients of ILD. Predicted forced vital capacity (FVC) and predicted forced expiratory volume in 1 s (FEV1) showed a good correlation with all the LUS parameters. B-line distance was the most significant LUS parameter to predict the variability in predicted FEVI, FVC, and MMRC dyspnea score. LUS severity score also showed good negative correlation with predicted FEV1 ( = -0.674, < 0.001) and predicted FVC ( = -0.65, < 0.001). LUS severity score of 4 or more predicted MMRC dyspnea score of > 3 with 82% sensitivity and 70% specificity.
Semi-quantitative LUS score and B-line distance can provide a simple but effective estimate of disease severity in ILD.
因此，准确分期疾病严重程度并进行连续监测是间质性肺疾病（ILD）有效管理方案的核心。
旨在评估肺部超声（LUS）半定量参数在ILD患者中作为疾病严重程度分期手段的有效性。
对47例ILD患者和20例年龄匹配的对照者进行LUS检查，记录如B线距离、胸膜增厚、胸膜下改变、肺滑动减弱和胸膜线破碎等结果，并使用这些参数进行LUS评分。将结果与改良医学研究委员会（MMRC）呼吸困难分级和肺功能参数进行比较。
B线和胸膜线破碎是ILD患者中最常见的表现。预计用力肺活量（FVC）和预计1秒用力呼气量（FEV1）与所有LUS参数均显示出良好的相关性。B线距离是预测预计FEV1、FVC和MMRC呼吸困难评分变异性的最显著LUS参数。LUS严重程度评分与预计FEV1（r = -0.674，P < 0.001）和预计FVC（r = -0.65，P < 0.001）也显示出良好的负相关性。LUS严重程度评分≥4预测MMRC呼吸困难评分>3，敏感性为82%，特异性为70%。
半定量LUS评分和B线距离可为ILD疾病严重程度提供简单而有效的评估。
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