Lung Ultrasound in Bronchopulmonary Dysplasia: A Comparative Diagnostic Study With CT, Chest X-Ray and Pulmonary...

Chest x-ray (CXR) and computed tomography (CT) are commonly used for diagnosing bronchopulmonary dysplasia (BPD), though each modality has limitations. CXR has low sensitivity for early parenchymal changes, while CT involves radiation exposure. Lung ultrasound (LUS) has emerged as a promising, radiation-free alternative.

To assess the diagnostic accuracy of LUS in BPD compared to CT and CXR, and to evaluate correlations between LUS scores and pulmonary function parameters, including spirometry, interrupter resistance technique (RINT), and nocturnal respiratory monitoring (pulse oximetry, polygraphy).

This was a retrospective, single-center, cross-sectional study conducted over 12 months at San Marco University Hospital (Catania, Italy). Sixty paediatric patients with BPD underwent LUS, CXR and high-resolution CT (HRCT). Pulmonary function tests (spirometry, RINT) and nocturnal monitoring were performed when feasible. Diagnostic performance of LUS was evaluated using receiver operating characteristic (ROC) curves and intraclass correlation coefficient (ICC). Correlations with functional parameters were analysed using Spearman's coefficient.

LUS showed good concordance with CT (ICC = 0.78; 95% CI: 0.72-0.85) and higher diagnostic accuracy than CXR (AUC = 0.87 vs. 0.67). LUS was particularly sensitive in detecting moderate parenchymal abnormalities. LUS scores correlated significantly with airway resistance (r = 0.85), FEV₁ (r = -0.65), and oxygen desaturation index (r = 0.50).

In this study, LUS demonstrated good concordance with CT and outperformed CXR. Its correlation with pulmonary function parameters suggests potential utility in the assessment and monitoring of BPD. Further studies with larger cohorts are needed to validate these findings.