The clinical indication for performing the HRCT scan was also collected when available as reported on slips or letters from the general practitioner or respiratory consultants. Patients were considered eligible if they were aged 18 years or over with capacity to provide valid informed consent.ĭemographics, smoking history and family history for respiratory disorders were collected. The relationship between audible “Velcro-type” crackles and radiologic HRCT patterns or individual features of pulmonary fibrosis was investigated using multivariate regression models.Ī total of 254 subjects referred to undergo HRCT scan of the chest for various clinical indications were consecutively recruited at the Radiology Units of the University Hospitals of Modena and Parma, Italy, between January 2013 and February 2015.
#Rales lung sounds cause full#
Audio files were independently assessed by two chest physicians and both full volume and single HRCT sections corresponding to the recording sites were extracted. Lung sounds were digitally recorded from subjects immediately prior to undergoing clinically indicated HRCT. In this prospective case-control study, we systematically investigate the relationships between audible digitally recorded “Velcro-type” crackles and HRCT features and patterns of FILD with the aim of providing substantial evidence as to the potential role of lung sounds as a screening and monitoring tool in ILD.
While international consensus guidelines recommend that IPF is suspected in all patients with bibasilar inspiratory “Velcro-type” crackles, the direct association between “Velcro-type” crackles and specific radiologic features of pulmonary fibrosis has not been thoroughly clarified.
Historically, “Velcro-type” crackles have been considered representative of established lung fibrosis, and quantitative analysis of crackles in ILD confirmed distinctive features as compared to those generated in other disorders such as chronic heart failure and pneumonia. “Velcro-type” crackles are brief, discontinuous pathological lung sounds, explosive and transient in character, named after their similarity to the sound generated by Velcro strips separating. Chest auscultation remains an important clinical assessment in patients with respiratory disorders, providing immediate and reliable information to clinicians. Recognition of signs and symptoms suggestive of FILD by healthcare practitioners represents a valuable point-of-care, low-cost opportunity for detection of early disease and timely diagnostic work up. Idiopathic pulmonary fibrosis (IPF) is the most frequent and deadly among FILD. Such evidence provides grounds for further investigation of lung sounds as an early identification tool in FILD.įibrotic interstitial lung disease (FILD) represents a diverse and challenging group of disorders with varied treatment strategies and prognoses. “Velcro-type” crackles predict the presence of FILD and directly correlate with the extent of distinct radiologic features of pulmonary fibrosis. Resultsġ48 subjects were enrolled: bilateral “Velcro-type” crackles predicted the presence of FILD at HRCT (OR 13.46, 95% CI 5.85–30.96, p < 0.001) and most strongly the Usual Interstitial Pneumonia (UIP) pattern (OR 19.8, 95% CI 5.28–74.25, p < 0.001). The relationships between audible “Velcro-type” crackles and radiologic HRCT patterns and individual features of pulmonary fibrosis were investigated using multivariate regression models.
Lung sounds were digitally recorded from subjects immediately prior to undergoing clinically indicated chest HRCT. This study investigated how “Velcro-type” crackles correlate with the presence of distinct patterns of FILD and individual radiologic features of pulmonary fibrosis on High Resolution Computed Tomography (HRCT). “Velcro-type” crackles on chest auscultation are considered a typical acoustic finding of Fibrotic Interstitial Lung Disease (FILD), however whether they may have a role in the early detection of these disorders has been unknown.
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