What is the role of lung ultrasonography in the evaluation for restrictive lung disease?

Updated: Sep 16, 2020
  • Author: Jonathan Robert Caronia, DO; Chief Editor: John J Oppenheimer, MD  more...
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Answer

Lung ultrasonography has a limited diagnostic role in the evaluation of pulmonary fibrosis. However, it may provide some information. A 3.5- to 7.5-MHz probe is placed on the chest wall, using the intercostal spaces as an acoustic window. A high-frequency (5-7.5MHz) “vascular” probe or a low-frequency (2.5-5Mhz) “cardiac” probe can be used. Use of a higher-frequency probe may yield more resolution at the pleural line.

Pulmonary fibrosis is associated with pleural thickening, especially in the lower posterior lobes. Notable lung sonographic findings include subpleural cysts and nodules, thickening of the pleural line, reductions in lung sliding, and the presence of sonographic B-lines. In a study of 52 patients with diffuse interstitial lung disease and 50 control patients, pleural-line abnormalities (irregularity, blurring, thickening, and fragmentation), B-lines, and subpleural consolidations (< 5 mm) were found to be characteristics of pulmonary fibrosis on lung sonography. [39]


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