This review should serve as a discussing paper for future prospective studies. In the present review, we discuss the current role of B-line artefacts (BLA) in pneumology and explore open questions of the published consensus ( 1). The parts of the diaphragm are displayed using a curved array transducer (B, arrow). Note the thoracic wall (wall), two muscle layers of the diaphragm next to the liver, separated by a fibrous septum (S) (A). The diaphragm can be directly visualized ( Figure 3).įigure 3 The anatomy of the parietal pleura and diaphragm is shown in a patient with a pleural effusion (PE). Therefore, imaging of the anatomy (direct ultrasound findings) ( Figure 1 with pneumonia) and indirect signs (artefacts) ( Figure 2) have to be differentiated. In addition to conventional lung ultrasound, mainly targeted to the evaluation of real anatomic images of pleural effusion (PE) pleural masses and lung consolidations, the analysis of artefacts has gained growing importance as features of lung disease. To interpret ultrasound findings of the thorax and lung it is crucial to know the current symptoms, clinical condition, medical history, physical examination and imaging findings ( 8). Thorax and lung ultrasound has gained importance in daily routine ( 1- 6) which is especially true in the setting of point of care ultrasound (POCUS) ( 7). Keywords: Guidelines pleural effusion (PE) consolidations pneumonia atelectasis malignancies pulmonary thromboembolism interstitial syndrome Further research is warranted to clarify technical adjustments, different probe and machine factors that influence the visualization of BLA.

Correct interpretation of BLA in lung ultrasound is strongly influenced by associated sonographic signs and careful integration of all relevant clinical information.Ĭonclusions: BLA is useful to monitor clinical response, and may become crucial in directing the diagnostic process. This condition may indicate different diseases including cardiogenic pulmonary edema, diffuse or focal interstitial lung diseases (ILD), infections and acute respiratory distress syndrome (ARDS). When multiple BLA is visualized in the lung, they represent a sign of increased density due to the loss of aeration in the lung periphery. Results: BLA imaging is influenced by more factors than recently assumed. Also, we presented observations on healthy subjects and patients with interstitial syndrome (pulmonary fibrosis and edema), to investigate technical factors influencing BLA visualization. Methods: We summarized current literature about BLA. In this review, we discuss the current role of BLA in pneumology and explore open questions of the published consensus. B-line artefact (BLA), caused by a reverberation phenomenon, is the most important lung artefact. 7, 97980 Bad Mergentheim, Deutschland 3Praxis for Internal Medicine, BahnhofstrRankweil, Austria 4University of South Carolina School of Medicine, Department of Emergency Medicine, Piedmont Hospital, Newnan Georgia, USA 5Department of Emergency Medicine, San Luigi Gonzaga University Hospital, Torino, Italy 6Diakonie Klinikum Jung-Stilling, Abteilung für Anästhesiologie, Intensiv- und Notfallmedizin, 57074 Siegen, Deutschland 7Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK 8Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China 9Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, ChinaĬontributions: (I) Conception and design: CF Dietrich (II) Administrative support: None (III) Provision of study materials or patients: CF Dietrich (IV) Collection and assembly of data: CF Dietrich (V) Data analysis and interpretation: CF Dietrich (VI) Manuscript writing: All authors (VII) Final approval of manuscript: All authors.īackground: The analysis of lung artefacts has gained increasing importance as markers of lung pathology. Atkinson 7, Xin-Wu Cui 1,8, Mei Fan 1,2, Dong Yi 9ġSino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China 2Caritas Krankenhaus Bad Mergentheim, Uhlandstr. Dietrich 1,2, Gebhard Mathis 3, Michael Blaivas 4, Giovanni Volpicelli 5, Armin Seibel 6, Daniel Wastl 2, Nathan S.

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