The Use of Ultrasound as a Tool to Evaluate Pulmonary Disease in Cystic Fibrosis

BACKGROUND: Lung ultrasound is an examination that allows the assessment of pulmonary involvement by analyzing artifacts. Our primary aim was to correlate our lung ultrasound findings with pulmonary function and the modified Bhalla score in patients with cystic fibrosis.

METHODS: Subjects with cystic fibrosis were evaluated based on the results of lung ultrasound, pulmonary function exams (ie, spirometry before and after the use of a bronchodilator and S_pO2), and the modified Bhalla score. The partial correlation set by age between lung ultrasound, pulmonary function, and modified Bhalla score was carried out. Lung ultrasound was graded according to a new score, ranging from 0 to 36, with a higher score being associated with a greater degree of involvement. We performed Bland-Altman and linear regression analysis to identify bias between lung ultrasound and modified Bhalla score. Alpha = 0.05.

RESULTS: 18 subjects with cystic fibrosis were included. In partial correlation controlled by age, we observed significant ultrasound score values with weight (partial correlation = −0.579), body mass index (partial correlation = −0.609), S_pO2 (partial correlation = −0.728), FVC% (pre-bronchodilator: partial correlation = −0.538; post-bronchodilator: partial correlation = −0.560), FEV₁% (pre-bronchodilator: partial correlation = −0.536; post-bronchodilator: partial correlation = −0.546), and modified Bhalla score (partial correlation = 0.607). We did not identify bias between lung ultrasound and modified Bhalla score measured by z-score.

CONCLUSIONS: Lung ultrasound seems to be effective and corroborates with high-resolution computed tomography when evaluated by the modified Bhalla score. At the same time, lung ultrasound had significant correlation with pulmonary function and nutritional status.