The Diagnostic Value of Lung Ultrasound in Bronchopulmonary Dysplasia Among Preterm Infants with Gestational Age ≤ 28 Weeks

Objective: The aim of this study was to explore the diagnostic value of lung ultrasound (LUS) for bronchopulmonary dysplasia (BPD) in extremely premature infants. Methods: This was a prospective observational cohort study in which infants with gestational age (GA) ≤ 28+6 weeks were included. LUS was performed at least once a week until 36 weeks of postmenstrual age. The LUS characteristics of infants with moderate–severe BPD were compared with those of infants with non–mild BPD. Results: A total of 114 infants were included, of which 69 (60.5%) had non–mild BPD, and 45 (39.5%) had moderate–severe BPD. The mean GA and birth weight of infants with non–mild BPD and moderate–severe BPD were 27.0 ± 1.4 and 26.3 ± 1.6 weeks and 969 ± 184 and 802 ± 228 g, respectively. The proportions of rough pleural lines, fused B-lines, patch-like anechoic appearance on the pleural surface, subpleural speckled hyperechoic appearance, lung consolidation (≥0.5 cm), fuzzy or invisible A-lines, and pleural insect erosion (PIE)-like changes in the moderate–severe BPD group were significantly greater than those in the non–mild BPD group (100% vs. 37.7%, 88.9% vs. 13.0%, 84.4% vs. 7.2%, 73.3% vs. 8.7%, 80.0% vs. 11.6%, 86.7% vs. 10.1%, and 75.6% vs. 5.8%, respectively; p < 0.001). In evaluating moderate–severe BPD, rough pleura had 100.0% (95% CI: 0.921–1.000) in sensitivity, 63.4% (95% CI: 0.518–0.736) in PPV, and 62.3% (95% CI: 0.505–0.728) in specificity. PIE-like changes had 75.6% (95% CI: 0.613–0.858) in sensitivity, 89.5% (95% CI: 0.759–0.958) in PPV, and 94.2% (95% CI: 0.860–0.977) in specificity. Pleura surface irregular patch-like anechoic had 84.4% (95% CI: 0.712–0.923) in sensitivity, 88.4% (95% CI: 0.755–0.949) in PPV, and 92.8% (95% CI: 0.841–0.969) in specificity. Subpleural speckled hyperechogenicity had 73.3% (95% CI: 0.592–0.840) in sensitivity, 84.6% (95% CI: 0.704–0.930) in PPV, and 91.3% (95% CI: 0.824–0.960) in specificity. Conclusions: LUS is a valuable tool for evaluating and diagnosing BPD.