Bronchial ultrasound imaging features of bronchial anthracofibrosis

Abstract:

Objective：To observe the characteristics of bronchial ultrasound imaging in patients with bronchial anthracofibrosis（BAF）and provide effective clinical clues for the prevention and treatment of the disease. Methods：From April 2018 to October 2019，113 patients with BAF who underwent bronchoscopy and treatment in the Department of Respiratory and Critical Care Medicine of People’s Hospital of Honghuagang District，Zunyi were selected as the research objects. BAF patients were classified into 31 cases of flat type，38 cases of deep retraction type，and 44 cases of mucosal protrusion type under the microscope. Except for black lesions，the lesions under microscope were statistically counted，such as bronchial swelling，bronchial occlusion，etc. The segmental and sub-segmental bronchus were examined by ultrasound with a small ultrasound probe to analyze the maximum tube wall and submucosal thickness，and to compare the average of the submucosal and bony tissue area of each subtype of BAF. Results：In this study，13 patients（11.5%） had a history of tuberculosis in the BAF group. In addition，57 patients（50.4%） were exposed to biofuels in the BAF group. The average exposure time was（17.4 ± 6.2） years，and the incidence of BAF accounted for 10% of the total number of bronchoscopy in our hospital. Using Image J 18.0 to magnify the airways of each BAF subgroup and measure the various indicators of the tube wall，it was found that the maximum wall thickness of the deep retracted type [（17.3±5.7） mm] and the black protruding type [（19.3±5.4） mm] was significantly higher than that of the flat group [（12.5±5.0） mm]，with statistically significant differences（P<0.05）. The maximum thickness of the submucosa of the deep retracted type [（9.8±3.0） mm] and the black protruding type [（14.5±5.0） mm] was significantly increased compared with the flat type [（6.6±3.5） mm]（P<0.05）. The area ratio of the bone tissue between the flat BAF group and the black protrusion type was （33.3±9.3）% and（34.9±12.1）%，which was significantly reduced than that of the deep retracted type [（65.2±8.7）%]（P<0.05），and the black protrusion type [（34.9±12.1）%] had no significant change compared with flat type（P>0.05）. Conclusion：The distal airway of patients with BAF has abnormal ultrasound imaging characteristics，and there are differences in the airway mucosal structure and bony imaging of different subtypes of BAF. Therefore，we speculate that bronchial ultrasound imaging and airway wall structure analysis may become important reference indicators for the diagnosis of different subtypes of BAF，and also provide clinical clues for understanding the characteristics of the distal airway.