Lung Ultrasound B Lines: Etiologies and Evolution with Age

Papa, G; Pellegrino, Giulia Michela; Volpicelli, Giovanni; Papa, Simone Sferrazza; Marco, Fabiano Di; Mondoni, Michele; Centanni, Stefano

doi:10.1159/000479034

Cited by 10 publications

(9 citation statements)

References 5 publications

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“…As a guide, a finding of a cluster of three or more B-lines per intercostal space may be pathological. However, the number of B-lines and the number of chest areas positive for (multiple) B-lines increases with age [21][22][23] and therefore one must be cautious of a false positive interpretation in older persons. The often-used term "interstitial syndrome" [13,24] is a description of ultrasound findings of pathological B-lines.…”

Section: Physiologic B-linesmentioning

confidence: 99%

A common misunderstanding in lung ultrasound: the comet tail artefact

2018

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The comet tail artefact is probably one of the most commonly and imprecisely used to describe vertical artefacts found in lung ultrasound. Two distinct artefacts are commonly observed: the lung comets and the B-lines. Both artefacts differ with regard to generation mechanism and clinical significance. This review explores the current understanding and use of these two artefacts in lung ultrasound and suggests how to avoid the pitfalls related to confusing comet tail artefacts with other vertical artefacts.

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Section: Physiologic B-linesmentioning

confidence: 99%

A common misunderstanding in lung ultrasound: the comet tail artefact

2018

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“…The new clinical and preclinical phase studies (Volpicelli et al, 2012;Soldati et al, 2015;Martelius et al, 2016;Sferrazza Papa et al, 2017;Buonsenso et al, 2020) describe the B-lines as vertical hyperechoic reverberations that move in synchrony with the lung and then as key artifacts in the interpretation of the lung ultrasound findings. According to this new point of view, the physiological basis of B lines is represented by a decreased lung aeration and they generally indicate an ultrasound non-specific finding (Volpicelli et al, 2012;Soldati et al, 2015;Sferrazza Papa et al, 2017). However, its quantitative characterization and according to the most recent studies also qualitative can be indicative of an ultrasound pattern more specific.…”

Section: Since 2015: Lung Ultrasound and The Reassessment Of Its Usementioning

confidence: 99%

“…Coley, 2011; Cattarossi, 2014;Coca Pérez et al, 2016;Martelius et al, 2016;Sferrazza Papa et al, 2017;Yousef, 2017;Joshi et al, 2019;Soldati et al, 2019;Buonsenso et al, 2020. Vertical artifacts of B-lines are seen as vertically oriented artifacts and indicate an abnormality in the interstitial or alveolar compartment.…”

Section: Sonographic Intesitial Syndrome (Figures 4 9)mentioning

confidence: 99%

“…-Cardiogenic origin (Figure 4) can be characterized by: typical B-lines or vertical artifacts (laser-like, bright) with the septal disposition (early stage); modulated B-lines (early stage); regular pleural line; the presence of pleural sliding; diffuse pulmonary involvement without spared areas (bilaterally); absence of consolidations, pleural nodules or pleural irregularities. Furthermore, they are all characteristics that can take on a dynamic aspect depending on the patient's position, the effects of the exercise and therapy (Coca Pérez et al, 2016;Martelius et al, 2016;Sferrazza Papa et al, 2017;Yousef, 2017;Joshi et al, 2019;Soldati et al, 2019;Buonsenso et al, 2020). -Pneumogenic origin (Figure 9) can be characterized by: unusual septal disposition of B-lines; blurred, uneven, coalescent B-lines and white lung; non-modulated B-lines or pseudo-B-lines; irregular pleural line; reduced pleural sliding; monofocal or multifocal, patchy or inhomogeneous involvement; consolidations, subpleural nodules or micronodules (generating pseudo-B-lines).…”

Section: Sonographic Intesitial Syndrome (Figures 4 9)mentioning

confidence: 99%

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Ten Years of Pediatric Lung Ultrasound: A Narrative Review

et al. 2022

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Lung diseases are the most common conditions in newborns, infants, and children and are also the primary cause of death in children younger than 5 years old. Traditionally, the lung was not thought to be a target for an ultrasound due to its inability to penetrate the gas-filled anatomical structures. With the deepening of knowledge on ultrasound in recent years, it is now known that the affected lung produces ultrasound artifacts resulting from the abnormal tissue/gas/tissue interface when ultrasound sound waves penetrate lung tissue. Over the years, the application of lung ultrasound (LUS) has changed and its main indications in the pediatric population have expanded. This review analyzed the studies on lung ultrasound in pediatrics, published from 2010 to 2020, with the aim of highlighting the usefulness of LUS in pediatrics. It also described the normal and abnormal appearances of the pediatric lung on ultrasound as well as the benefits, limitations, and possible future challenges of this modality.

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“…Several authors noted that TTN is characterized by spared lung areas and no consolidation, whereas RDS involves the entire lung bilaterally with interspersed consolidations [15,17]. The double-lung point (very compact B-lines in the inferior pulmonary fields and scattered B-lines in the superior ones [18]), once thought to be pathognomonic for TTN, has been recently demonstrated to be a non-specific sign [19,20]. Rachuri et al [17] showed that LUS was more accurate in distinguishing neonatal respiratory distress aetiology with respect to CXR.…”

Section: Lus In Neonatal Diseasesmentioning

confidence: 99%

Usefulness of Lung Ultrasound in Paediatric Respiratory Diseases

et al. 2021

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Respiratory infection diseases are among the major causes of morbidity and mortality in children. Diagnosis is focused on clinical presentation, yet signs and symptoms are not specific and there is a need for new non-radiating diagnostic tools. Among these, lung ultrasound (LUS) has recently been included in point-of-care protocols showing interesting results. In comparison to other imaging techniques, such as chest X-ray and computed tomography, ultrasonography does not use ionizing radiations. Therefore, it is particularly suitable for clinical follow-up of paediatric patients. LUS requires only 5–10 min and allows physicians to make quick decisions about the patient’s management. Nowadays, LUS has become an early diagnostic tool to detect pneumonia during the COVID-19 pandemic. In this narrative review, we show the most recent scientific literature about advantages and limits of LUS performance in children. Furthermore, we discuss the major paediatric indications separately, with a paragraph fully dedicated to COVID-19. Finally, we mention potential future perspectives about LUS application in paediatric respiratory diseases.

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Lung Ultrasound B Lines: Etiologies and Evolution with Age

Cited by 10 publications

References 5 publications

A common misunderstanding in lung ultrasound: the comet tail artefact

A common misunderstanding in lung ultrasound: the comet tail artefact

Ten Years of Pediatric Lung Ultrasound: A Narrative Review

Usefulness of Lung Ultrasound in Paediatric Respiratory Diseases

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