Ultrasound assessment of diaphragmatic motion in patients with interstitial lung disease

Introduction: Interstitial lung diseases (ILD) include many heterogenous diseases with variant prognosis. Dyspnea is one of the leading clinical symptoms of parenchymal lesions, mainly associated with severe lung involvement. Additionally diaphragm dysfunction might be associated with increased effort dyspnoe. Our aim was to assess diaphragm dysfunction by ultrasound in ILD patients. Methods: 107 clinically ILD suspected patients were prospectively enrolled, who underwent fluoroscopy, HRCT and M-mode ultrasound as part of the clinical investigation to determine the extent of diaphragm motion. Results: ILD was confirmed in 58 patients (61.3±13.3 years). We observed mild decrease of lung function test parameters compared to the physiological values: forced vital capacity (FVC: 72.8 ± 23.6% predicted), total lung capacity (TLC 67.8 ± 18.6 % predicted), and TLco (74.6 ± 17.5 %predicted). 69.8% of patients had decreased diaphragmatic movement using fluoroscopy. Significant correlation of diaphragm motion was found between the three modalities, fluoroscopy and HRCT showed higher correlation (right: r = 0.678, left: r = 0.518, p Conclusion: Exertional dyspnea is a major source of crippling distress and is the hallmark symptom of ILD patients. Diaphragm motion disorder, slight decrease of static lung volumes and diffusion can be frequently observed in the background. M-mode ultrasound appears to be a reliable method for diagnosing and follow-up the diaphragm dysmotility in ILD patients.