The artificial count of artifacts for thoracic ultrasound: what is the clinical usefulness?

Sensitivity of Lung US compared to Chest CT for the screening of COVID-19: preliminary report of our experience

“…In particular, the sensitivity of an echographic pattern consisting in a blurred and thickened hyperechoic pleural line with B-lines below it in detecting a CT peripheral "crazy-paving" pattern of GGOs was of only 52%. Nevertheless, this artifactual US pattern is an unreliable, poor reproducible and potentially misleading diagnostic approach, due to variability among different intra-and inter-operator B-lines counting and ultrasound scan settings 19 . Indeed, the erroneous use of a medium-to-low frequency probe or excessive total gain and the lack of tissue harmonic imaging can generate a large number of such artifacts.…”

“…Indeed, the erroneous use of a medium-to-low frequency probe or excessive total gain and the lack of tissue harmonic imaging can generate a large number of such artifacts. Furthermore, the increase in the pleural line movement rate in dyspneic patients or the simple change of positioning of the probe with respect to the curvature of the patient's chest can in uence the perceptual semi-quantitative evaluation of B-lines 19 .…”

“…Since the initial cluster of pneumonia cases in Wuhan in December 2019 1 , the so-called SARS-CoV-2 has sudden spread globally and the World Health Organization (WHO) declared the novel coronavirus disease (COVID- 19) as "a pandemic" on 11 March 2020 2 .…”

Lung ultrasound early detection and monitoring in COVID-19 pneumonia: fact and fiction

“…B-lines and have been initially described in fluid filled dilated bowel loops: in lung, B-lines are visible where the proportion of air/liquid film changes: this happens in pulmonary edema, pneumonia, atelectasis, acute lung injury/acute respiratory distress syndrome, pleural effusion (also minimal), acute exacerbation of chronic obstructive pulmonary disease, neoplastic lymphangitis, pulmonary fibrosis, any ground-glass opacity that may be seen in CT. Comparing the actual number of B-lines, coalescent or non-coalescent, between patients' groups with any of the above listed heart or pleural-pulmonary diseases, 5 no statistical difference is found.…”

The Role of Transthoracic Ultrasound in the novel Coronavirus Disease (COVID-19): A Reappraisal. Information and Disinformation: Is There Still Place for a Scientific Debate?

“…Nevertheless, there is still not a standardized consensus on the ultrasound scan machine setting, as well as the type and frequency of the probe, which have to be used to perform a transthoracic ultrasound examination of the lung. The use of a medium-to-low frequency or excessive total gain (>50%) and the lack of tissue harmonic imaging can generate a larger number of ultrasound artifacts and this may result in another source of bias (9). Despite this, none of these recent articles, exalting the role of a lung ultrasound in the diagnosis of COVID-19, specify the setting of the ultrasound equipment employed.…”