This study explores the potential of point-of-care lung ultrasound (POCUS) as a noninvasive tool for detecting early lung changes in preschool children with cystic fibrosis (CF), particularly as an alternative to high-resolution computed tomography (HRCT), which, while effective, exposes patients to ionizing radiation. Given that respiratory complications are the leading cause of mortality in CF, early detection of lung abnormalities is essential. In this case-control study, 70 children aged between 31 months and 6 years were enrolled, including 20 with CF and 50 healthy controls. All participants were asymptomatic with no recent respiratory issues and had not received antibiotics within 30 days before the study.
Using POCUS, researchers assessed two specific ultrasound markers: B-lines (related to fluid accumulation in the lungs) and subpleural consolidations, or small areas of lung tissue changes close to the pleura. The results revealed that children with CF had significantly higher rates of B-lines and subpleural consolidations under 1 cm, both in terms of prevalence and frequency. For instance, B-lines were present in nearly half (47.73%) of the control group, but subpleural consolidations were notably rare (only 2.27%). CF patients, however, showed these consolidations with much higher frequency (p = 0.0001). Additionally, coalescent B-lines—where lines converge due to more significant fluid presence—were more prevalent in infants than in children aged 2-6, suggesting an age-related pattern.
The study concludes that the presence of small subpleural consolidations in asymptomatic children with CF could be an ultrasound marker for early-stage lung disease. Thus, POCUS could offer clinicians a useful diagnostic approach that avoids radiation exposure, allowing for safer, earlier monitoring of lung health in CF children. Such ultrasound-based assessments could become part of standard care in tracking CF progression in young patients without invasive procedures.
