LUNG ULTRASOUND

Hassan Alsinan
 ADVANTAGES
• Real-time scanning for immediate integration of the results into a
management plan

• Detection of pleural pathology : more sensitive than chest radiography at

detecting the presence of pleural fluid and differentiating pleural fluid from
lung consolidation in the critically-ill

• Reduced cost and radiation exposure

 INDICATIONS
Pneumothorax
Pulmonary edema
Chest infection (Lung consolidation)
Pleural effusion
Rib fracture
 PROBE

• Linear probe for superficial structure (pleura “lung

sliding”)

• Curvilinear and Phased-array probe for deep

structures (B lines, consolidation and diaphragm)
VIEWS
NORMAL US (BAT SIGN)
NORMAL : A-LINES
NORMAL : M-MODE
PNEUMOTHORAX: LUNG SLIDING
PNEUMOTHORAX : LUNG POINT
PNEUMOTHORAX : BARCODE SIGN
 B-LINES
• The B-line includes 7 criteria:
1. Vertical lines.
2. It arises from the pleural line.
3. It moves in concert with lung sliding.
4. It does not fade, descends up to 10-15 cm
5. It is well-defined, laser like.
6. It is hyperechoic, like the pleural line.
7. It obliterates the A-lines. All these criteria make it always possible to recognize B-
lines from other lines (E-lines, Z-lines...).
PULMONARY EDEMA
PULMONARY EDEMA
 LUNG CONSOLIDATION
• The US features of Pneumonia are:
1- Unilateral B-lines and tiny areas of sub pleural consolidation.
2- Solid appearing consolidated lung – hepatization looks like liver.
3- Irregular consolidation / the shred sign.
4- Dynamic air bronchograms in Pneumonia.
5- Pneumonia with C-Lines ( broken pleura ).
PNEUMONIA
PNEUMONIA : SHRED SIGN
PNEUMONIA : AIR
BRONCHOGRAMS
PNEUMONIA
 PLEURAL EFFUSION
• Effusions as small as 5 mL can be detected ultrasonographically with 100%
sensitivity

• US feature of pleural effusion is spine sign (it represents the visualization of

the vertebral bodies in the thoracic cavity above the diaphragm which are usually not
seen unless there is a fluid collection ).
SPINE SIGN
SPINE SIGN
RIB FRACTURE
PULMONARY CONTUSION
Normal lung with A lines can briefly be seen
until the sonographer moves the probe superiorly
to see area of B lines adjacent to A line.
THANK YOU!