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Features of lung ultrasound in COVID 19 infection

The 12-zone method involves dividing the chest into 6 zones demarcated by the anterior axillary and posterior axillary lines and then into upper and basal regions. This is repeated for the other side. 2 sides therefore 12 zones.

The characteristic findings included:

  • Thickening of the pleural line with pleural line irregularity;
  • B lines in a variety of patterns including focal, multifocal, and confluent;
  • Consolidations in a variety of patterns including multifocal small, non-translobar, and translobar with occasional mobile air bronchograms;
  • The appearance of A-lines during recovery phase
  • Pleural effusions are uncommon.

lung ultrasound clinical

 

They compared lung CT with lung ultrasound features in the table below

Table 1 CT and ultrasonographic features of COVID-19 pneumonia

Lung CT

Lung ultrasound

Thickened pleura

Thickened pleural line

Ground glass shadow and effusion

B lines (multifocal, discrete, or confluent)

Pulmonary infiltrating shadow

Confluent B lines

Subpleural consolidation

Small (centomeric) consolidations)

Translobar consolidation

Both non-translobar and translobar consolidation

Pleural effusion is rare.

Pleural effusion is rare

More than two lobes affected

Multilobar distribution of abnormalities

Negative or atypical in lung CT images in the super-early stage, then diffuse scattered or ground glass shadow with the progress of the disease, further lung consolidation

Foca B lines are the main feature in the early stage and in mild infection; the alveolar interstitial syndrome is the main feature in the progressive stage and in critically ill patients; A-lines can be found in the convalescence; pleural line thickening with uneven B lines can be seen in patients with pulmonary fibrosis

 

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