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Background: Ultrasound examination pulmonary 3D/4D, elastography and strain rate will constitute a revolution in the coming years. The strain measures the degree of deformation and allows the pulmonary regional and global quantification. It is reproducible and not time consuming. The study aims to evaluate the behavior of the bronchial structure in patients with COPD and asthma using the methods of strain and strain rate (SR).
Methods: The study included critically ill adult patients with early, severe COPD (n = 21) and bronchial asthma (n = 12) were included retrospectively, as well as healthy controls (n = 11). Standard lung ultrasound examinations, including 3D/4D análysis, Elastography, were identified and the studies were then reanalysed for assessment of lung strain using speckle-tracking. Lung tracing of the lung was performed in pleural space, pulmonar parenchyma, bronchial estructures and lung vascular estructures determining the longitudinal score and free wall strain in each subject. Spirometry was performed in all patients.
Results: Compared to the control group (healthy subjects) it found that all patients in both groups showed changes the degree of deformation. In 81% of patients with COPD Spirometry showed a mixed pattern (obstructive and restrictive) and 80% of them improved by applying bronchial bronchodilator therapy in the time of scanning. 100% of asthmatic patients had obstructive spirometric pattern and post bronchodilator to treat me there was improvement at all. During the analysis it was found that the values of critical deformation in 12 patients with COPD lines showed increased lung B, the expression of pulmonary congestion.
Conclusions: The study shows that longitudinal and global analysis of bronchial deformation can detect measurable changes in COPD and moderate to severe asthma. With increased pulmonary congestion and there is greater presence of lines B values deformation lung is affected. No patients with COPD and Asthma regular strain had worsened.
3D/4D: Ultrasound volume scan, B lines: vertical lines pulmonary artifacts, Strain/Strain Rate: deformations scores, SR: strain rate, COPD: chronic obstructive pulmonary disease., COPD, Pulmonary Fibrosis, Pneumoconioses