Evaluation of ultrasound lung comets by hand-held echocardiography

Summary. Background: The diagnosis of community-acquired pneumonia (CAP) is based mainly on the patient's medical history and physical examination. However, in severe cases a further evaluation including chest X-ray (CXR) may be necessary. At present, lung ultrasound (LUS) is not included in the diagnostic work-up of pneumonia. Aim: To describe the ultrasonographic appearance of CAP at presentation and during the follow-up. Methods: A total of 102 patients with clinical signs and symptoms suggesting pneumonia, who underwent a clinically driven CXR, were evaluated by LUS on the same day. LUS signs of pneumonia included subpleural lung consolidation, B-lines, pleural line abnormalities, and pleural effusion. The diagnostic gold standard was the ex-post diagnosis of pneumonia made by two independent experienced pediatricians on the basis of clinical presentation, CXR and clinical course following British Thoracic Guidelines recommendations. Results: A final diagnosis of pneumonia was confirmed in 89/102 patients. LUS was positive for the diagnosis of pneumonia in 88/89 patients, whereas CXR was positive in 81/89. Only one patient with normal LUS examination had an abnormal CXR, whereas 8 patients with normal CXR had an abnormal LUS. LUS was able to detect pleural effusion resulting from complicated pneumonia in 16 cases, whereas CXR detected pleural effusion in 3 cases. Conclusions: LUS is a simple and reliable imaging tool, not inferior to CXR in identifying pleuro-pulmonary alterations in children with suspected pneumonia. During the course of the disease, LUS allows a radiation-free follow-up of these abnormalities.

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“…29 However, the LUS learning curve is relatively fast and simple compared to other ultrasound applications. [12][13] …”

Section: Discussionmentioning

confidence: 99%

“…LUS has a very good intra-and inter-observer variability, as previously described. [11][12][13] LUS findings were classified according the following patterns: …”

Section: Lus Examinationmentioning

confidence: 99%

Lung ultrasound characteristics of community‐acquired pneumonia in hospitalized children

Caiulo

Gargani

Caiulo

et al. 2012

Pediatric Pulmonology

174

161

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“…B lines were recognized as a hyperechogenic, coherent bundle with narrow basis spreading from the transducer to the further border of the screen, as described by Bedetti et al 9 B lines are the ultrasonographic expression of interlobular pulmonary septa thickened by edema.…”

Section: Evaluation Of Lung Congestionmentioning

confidence: 99%

Variables associated with lung congestion as assessed by chest ultrasound in diabetics undergoing hemodialysis

Santos¹,

Neto²,

Carneiro³

et al. 2017

Jornal Brasileiro De Nefrologia

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“…В первую фазу нарушение нормального соотно-шения воздуха и жидкости визуализируется в виде артефакта (реверберации), представляющего со-бой линейные гиперэхогенные сигналы, поддаю-щиеся счету и называемые кометами [3,4,6,9,14,15,17] или В-линиями [13,21]. Появление таких линий принято считать свидетельством так называ-емого интерстициального синдрома [12,16,22,23].…”

Section: сос тояние проб лемыunclassified

Interstitial Syndrome And Alveolar Consolidation: Sonographic Markers of Hemodynamic Pulmonary Edema In Infants

et al. 2017

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With the purpose of evaluating the possibility of describing hemodynamic pulmonary edema in infants with congenital heart disease using the previously suggested sonographic phenomena “alveolar consolidation” and “interstitial syndrome” in adults, 131 children of both genders were examined at the age of 1-246 days. Of these infants, 47 had congenital heart anomalies, 51 had chronic somatic pathology and patent foramen ovale, and 33 had a somatic pathology associated with either congenital heart disease or small heart abnormalities. The duration of observation and the number of sessions of ultrasound scanning were determined by the health status dynamics of the infants. All infants were described in terms of 179 characteristics of physical examination and laboratory and instrumental findings obtained through standard procedures. Echocardiography and ultrasound lung scans were performed with LOGIQ E (General Electric) and HD11 (Philips) using linear, convex, and sector transducers (7-12, 3-5, and 1.7-4.0 МHz respectively). In addition to standard protocols of heart and lung description, we also registered the square of consolidated parcels summarized for all lung segments, the number of B-lines summarized for all lung segments, and the swing of diaphragm and lung movement and calculated the diaphragm and lung swing ratio. An attempt to describe the differences between pulmonary circulation in terms of ultrasound sonography for heart defects associated and not associated with blood filling in the lungs was successful. The total area of air-free/consolidated subpleural parcels of lungs and the extent of interstitial lung syndrome were the most informative sonographic characteristics. It was concluded that interstitial edema and alveolar consolidation, described in terms of transthoracic ultrasound sonography, are recommended for use as markers of the disorders of pulmonary circulation associated with congenital heart malformations in infants.

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Evaluation of ultrasound lung comets by hand-held echocardiography

Abstract: Background: Ultrasound lung comets (ULCs) are a clinically useful sign of extravascular lung water. They require very limited technology (2 D-echo), and a short learning curve.

Cited by 202 publications

References 16 publications

Lung ultrasound characteristics of community‐acquired pneumonia in hospitalized children

Lung ultrasound characteristics of community‐acquired pneumonia in hospitalized children

Variables associated with lung congestion as assessed by chest ultrasound in diabetics undergoing hemodialysis

Interstitial Syndrome And Alveolar Consolidation: Sonographic Markers of Hemodynamic Pulmonary Edema In Infants

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