Tracheoechography versus CT tracheography for assessment of idiopathic pulmonary fibrosis related tracheopathy

Background: Idiopathic pulmonary fibrosis (IPF) is a specific type of chronic, progressive interstitial pneumonia with fibrosing nature of tracheobronchial tree. Purpose: Assessment of tracheographic changes associated with or induced by (IPF) using echotracheography in contrast to computed tomography (CT) neck for tracheal examination. Patients and methods: A prospective study was conducted on 62 IPF patients subjected to CT neck followed by transtracheal ultrasonography with assessment of internal transverse tracheal diameter, tracheal wall thickness, central tracheal wall depth, tracheal echogenicity, histogram and endoluminal lesions. Results: Internal transverse tracheal diameter, tracheal wall thickness and central tracheal wall depth were lower in IPF patients than control cases by both tracheoechographic and CT tracheographic assessment. Internal transverse tracheal diameter showed very weak agreement like tracheal wall thickness that showed weak agreement unlike central tracheal wall depth that showed very good agreement with CT neck. Degree of variation between ultrasound (US) and CT was low regarding tracheal wall thickness and central tracheal wall depth (6.6% and 2.7%, respectively). Tracheoechography entirely in our study presented acceptable degree of agreement (k = 0.53) and low degree of variation (4.5%) in contrast to CT trachea. Significant statistical differences were present regarding degree of agreement denoting presence of strong differences between IPF patients and control cases. Conclusion: IPF can be well thought-out as fibrotic lung disease may be linked with tracheal fibrotic changes that portent the process of airway affection using ultrasonography. Tracheoechography can substitute for diagnostic dilemma of IPF induced tracheal changes akin to CT tracheography