Gray-Scale Ultrasonography of Lung and Sonoelastography of the Diaphragm in Interstitial Lung Disease With HRCT Association

Interstitial lung disease (ILD) is a heterogeneous group of disorders characterized by diffuse inflammation of the pulmonary parenchyma and alveoli, along with interstitial fibrosis. High-resolution computed tomography (HRCT) of the thorax remains the mainstay for diagnosis. Adjunct tools for diagnosis and follow-up imaging include gray-scale lung ultrasonography (LUS) and sonoelastography of the diaphragm, or diaphragm elastography (DE); however, limited research has been conducted on LUS and DE in patients with ILD. We conducted a cross-sectional observational study using LUS and DE in 56 patients diagnosed with ILD on HRCT. We found a strong correlation ( P <0.05) between ground-glass opacities (GGOs) and reticulations on HRCT with the B-line score on LUS, indicating its reliability in assessing early and diffuse interstitial changes. In contrast, the presence of honeycombing on CT showed better correlation (correlation coefficient r 0.49) with stiffer diaphragms as compared with GGO (correlation coefficient r 0.14), suggesting its potential role in evaluating advanced fibrotic changes. Hence, we concluded that combining LUS and DE may enhance diagnostic and staging accuracy for ILD, eliminating patient exposure to ionizing radiation.