A Study on Characteristics and Diagnostic Capability of Pulmonary Sonography in Interstitial Lung Disease

Abstract Background: Pulmonary sonography, alternatively called lung ultrasonography (LUS), is rapidly evolving as an imaging technology, reaching mid-sized and smaller medical centers quickly. This radiation-free, non-hazardous diagnostic modality is gaining importance in interstitial lung disease (ILD) because of its superior ability to detect B-line artifacts, which result from altered pathophysiological changes in the interstitial lung tissue. This study aims to determine the role and extent of pulmonary sonography in diagnosing ILD, in comparison with high-resolution computed tomography (HRCT), which is the current gold standard. Materials and Methods: This retrospective observational study was conducted from August 2021 to May 2024 at Apollo Main Hospitals, Chennai. A total of 302 patients (aged 18–88 years) presenting with clinical signs and symptoms of ILD were included. Lung ultrasound was performed with a Philips EPIQ 7 device using convex and linear probes across 14 intercostal spaces to assess B-lines. HRCT was conducted using a Toshiba Aquilion scanner. Routine initial tests included chest X-ray and pulmonary function tests. Acoustic Radiation Force Impulse (ARFI) quantitative elastography is an established technology used in this research to evaluate muscle sarcopenia. Statistical analyses were performed using SPSS version 28.0. Results: Statistical analysis showed that 93.7% (283 patients) could be diagnosed ILD using LUS. The mean B-line score in LUS was 19.04 ± 7.63, with a significant difference between the right and left lungs ( P = 0.041). A significant negative correlation was found between the B-line score and ARFI muscle values (rho = −0.132, P = 0.022), suggesting an association with sarcopenia in ILD. No significant correlation was observed between the B-line score and demographic variables or comorbidities. Conclusion: LUS is a versatile imaging method and an essentially reliable resource for assessing a given situation in evaluating ILD, closely comparable with HRCT to the highest degree. LUS is non-hazardous, reproducible, and cost-effective for initial assessment and follow-up, especially when HRCT is not clinically indicated.