Milad Nasrollahzadeh, Esmaeil Idani, Atefeh Abedini, Mehran Malekshoaar, Mohsen Sadeghi, Maryam Kasravi, Rozhin Tofighi, Ghazal Roostaei, Arda Kiani
Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Pulm Med. 2025 Jan 9;25(1):11. doi: 10.1186/s12890-024-03433-8.
This study aims to compare Lung Ultrasound (LUS) findings with High-Resolution Computerized Tomography (HRCT) and Pulmonary Function Tests (PFTs) to detect the severity of lung involvement in patients with Usual Interstitial Pneumonia (UIP) and Non-Specific Interstitial Pneumonia (NSIP).
A cross-sectional study was conducted on 35 UIP and 30 NSIP patients at a referral hospital. All patients underwent LUS, HRCT, and PFT. LUS findings such as B-lines, pleural fragmentation, and pleural thickening were compared with HRCT-based lung involvement and PFT parameters.
In UIP patients, B-lines > 18 and pleural fragmentation significantly differentiated between < 50% and > 50% HRCT involvement. A logistic regression model showed that B-lines > 18 (OR = 39, p = 0.04) and pleural fragmentation (OR = 22, p = 0.037) independently predicted > 50% HRCT involvement. ROC analysis of the model revealed 84.2% sensitivity and 84.5% specificity. Furthermore, the crude number of B-lines (OR = 1.2, p = 0.038) and > 50% HRCT involvement (OR = 9.5, p = 0.045) independently predicted severe DLCO impairment, with a sensitivity of 94.7% and specificity of 84.5%. Linear regression showed that each additional B-line was associated with a 0.4% decrease in DLCO (Beta = -0.377, p = 0.043), independent of patient diagnosis. In NSIP patients, no significant correlation was observed between LUS findings and > 50% HRCT involvement (p > 0.05), though B-line numbers and pleural thickening increased in cases with severe DLCO impairment (p < 0.05).
LUS shows promise as a sensitive, radiation-free alternative to HRCT in monitoring the severity of UIP. It is particularly valuable in predicting the extent of lung involvement and severe DLCO impairment in UIP patients but has limited application in NSIP.
本研究旨在比较肺部超声（LUS）检查结果与高分辨率计算机断层扫描（HRCT）及肺功能测试（PFT）结果，以检测寻常型间质性肺炎（UIP）和非特异性间质性肺炎（NSIP）患者肺部受累的严重程度。
在一家转诊医院对35例UIP患者和30例NSIP患者进行了一项横断面研究。所有患者均接受了LUS、HRCT和PFT检查。将LUS检查结果（如B线、胸膜破碎和胸膜增厚）与基于HRCT的肺部受累情况及PFT参数进行比较。
在UIP患者中，B线>18条和胸膜破碎在HRCT受累<50%和>50%的患者之间有显著差异。逻辑回归模型显示，B线>18条（OR=39，p=0.04）和胸膜破碎（OR=22，p=0.037）可独立预测HRCT受累>50%。该模型的ROC分析显示敏感性为84.2%，特异性为84.5%。此外，B线的原始数量（OR=1.2，p=0.038）和HRCT受累>50%（OR=9.5，p=0.045）可独立预测严重的一氧化碳弥散量（DLCO）受损，敏感性为94.7%，特异性为84.5%。线性回归显示，每增加一条B线，DLCO下降0.4%（β=-0.377，p=0.043），与患者诊断无关。在NSIP患者中，LUS检查结果与HRCT受累>50%之间未观察到显著相关性（p>0.05），尽管在严重DLCO受损的病例中B线数量和胸膜增厚有所增加（p<0.05）。
在监测UIP的严重程度方面，LUS有望成为一种敏感的、无辐射的HRCT替代方法。它在预测UIP患者肺部受累程度和严重DLCO受损方面特别有价值，但在NSIP中的应用有限。
