Transthoracic Sonography Versus High Resolution Computed Tomography in Alveolar Intersitial Syndrome

Can High Frequency Transthoracic Sonography Play a Competition Role With High Resolution Computed Tomography in Assessment of Alveolar Intersitial Syndrome

High resolution computed tomography of the chest is the gold standard imaging modality for most pulmonary diseases. However, the associated high expenses, radiation exposure , and its limited possibility for bedside use are a limitation.

High resolution computed tomography of the chest is the gold standard imaging modality for most pulmonary diseases. However, the associated high expenses, radiation exposure , and its limited possibility for bedside use are a limitation. Transthoracic ultrasonograghy is used progressively for evaluation of pulmonary diseases. Its non invasive nature , relatively low price ,portability for bedside use, and high reproducibility of results allows for incorporation of imaging findings with clinical data. Although Transthoracic ultrasonograghy is not an alternative to High resolution computed tomography,it can potentially provide useful supplemental information in certain specific situations ,such as for rapid bedside diagnostic assessment of dyspneic patients. B-line is a common and significant abnormal sign used for diagnostic appraisal by Transthoracic ultrasonograghy, but it cannot define the exact underlying pathologic feature on a lung ultrasound. When the lung parenchymal pathology reaches the lung surface ,certain characteristic changes of the pleural line can be detected by means of the good imaging made possible by high-resolution Transthoracic ultrasonograghy ,but the application and strength of pleural line abnormalities in the differential diagnosis of lung diseases has not been adequately explored . Existing literature on the illustration of the pleural line is scarce ,and the shape of pleural line has not been adequately investigated and described ,especially in comparison with Computed tomography findings. Most studies that have investigated pleural lines are confined to the sub population with interstitial lung diseases.

Patients will be included in the study when High resolution chest computed tomography without contrast enhancement is ordered by the primary physician. Before the High resolution chest computed tomography scan, a Trans thoracic ultrasonography will be performed.

High resolution computed tomography of the chest is the gold standard imaging modality for most pulmonary diseases

Trans thoracic ultrasonograghy is used progressively for evaluation of pulmonary diseases . Its non invasive nature , relatively low price ,portability for bedside use, and high reproducible of results allows for incorporation of imaging findings with clinical data

Inclusion Criteria: Patients presenting with dyspnea due to interstitial fibrosis syndrome. pulmonary edema due to any cause. Exclusion Criteria: Traumatic lesions Pneumothorax Subcutaneous emphysema Massive pleural effusion with atelectasis, and

Sartori S, Tombesi P. Emerging roles for transthoracic ultrasonography in pleuropulmonary pathology. World J Radiol. 2010 Feb 28;2(2):83-90. doi: 10.4329/wjr.v2.i2.83.

Frenz MB, Mee AS. Diagnostic radiation exposure and cancer risk. Gut. 2005 Jun;54(6):889-90. doi: 10.1136/gut.2005.066605. No abstract available.

Volpicelli G, Mussa A, Garofalo G, Cardinale L, Casoli G, Perotto F, Fava C, Frascisco M. Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome. Am J Emerg Med. 2006 Oct;24(6):689-96. doi: 10.1016/j.ajem.2006.02.013.

Smargiassi A, Inchingolo R, Soldati G, Copetti R, Marchetti G, Zanforlin A, Giannuzzi R, Testa A, Nardini S, Valente S. The role of chest ultrasonography in the management of respiratory diseases: document II. Multidiscip Respir Med. 2013 Aug 9;8(1):55. doi: 10.1186/2049-6958-8-55.

Leech M, Bissett B, Kot M, Ntoumenopoulos G. Lung ultrasound for critical care physiotherapists: a narrative review. Physiother Res Int. 2015 Jun;20(2):69-76. doi: 10.1002/pri.1607. Epub 2014 Dec 29.

Lichtenstein D, Meziere G, Biderman P, Gepner A, Barre O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med. 1997 Nov;156(5):1640-6. doi: 10.1164/ajrccm.156.5.96-07096.