Transthoracic lung ultrasound in the monitoring of interstitial lung disease: a case of scleroderma

Abstract

The goal of this study was to compare monitoring of lung lesions in interstitial lung disease by transthoracic lung ultrasound (TLUS) to monitoring by high-resolution computed tomography (HRCT), before and after treatment with cyclophosphamide. The patient was hospitalized because of gradually increasing exertional dyspnea. Positive findings in the physical examination were: exertional dyspnea, asymmetric rales at the base of both lungs, joint pain (VAS7), digital edema, sclerodactylia, microstomia, telangiectasia, and Raynaud's phenomenon. Percutaneous oxygen saturation during moderate exercise was low (88%) while normal was at rest (95%). Immune test results included positive antinuclear antibodies Hep-2 antibodies (1:10 240, light type nucleolar) and markedly positive Scl-70 antibodies. Pulmonary function tests reported a reduction in diffusing capacity of the lung for carbon monoxide (60%). The first HRCT study showed fibrotic lesions, mainly in the lower lobes, and ground-glass opacity in the middle fields of the lungs (FIGURE A1, B1). TLUS

Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound

“…So far, the literature in the diagnosis of pulmonary fibrosis has been based mainly on B-line artifacts [18]. It has been proved, inter alia, that the more severe the pulmonary fibrosis, the more B-line artifacts are visible on lung ultrasound images [19][20][21][22]. The publications also emphasized the importance of coexistence with B-line artifacts of lesions in the pleural line [23][24][25][26][27][28].…”

Lung ultrasound in the diagnosis of COVID-19 infection - A case series and review of the literature

“…The fibrotic process may constitute the adverse outcome of the healing of inflammatory lesions. Ultrasonographic features of pulmonary fibrosis are comprehensively described in medical literature and involve characteristic abnormalities within the pleural line (irregular, coarse in appearance, fragmented, or blurred) and B-line artifacts [18][19][20]. In this case, similar to interstitial pneumonia of a viral etiology, the more B-line artifacts are visible, the more significantly the interstitial tissue is affected [20].…”

Usefulness of lung ultrasound B-lines in connective tissue disease-associated interstitial lung disease: a literature review

“…Furthermore, the majority of studies focused on B-lines as a diagnostic tool in ILD. No data are yet available on B-lines for follow-up in rheumatic disease patients, nor on the accuracy of this method to assess the eventual response to therapy (only two case reports are available) [ 45 , 46 ], nor on the correct timing of LUS for diagnosis and follow-up. All studies up to now have included rather small populations from a single centre.…”