Ultraschall Med 2023; 44(01): 14-35
DOI: 10.1055/a-1885-5664
Continuing Medical Education

Pulmonary Sonography – Neonatal Diagnosis Part 1

Article in several languages: English | deutsch
Clinic for Pediatrics and Adolescent Medicine, Sana Kliniken Duisburg GmbH, Duisburg, Germany
› Author Affiliations

Abstract

Diseases of the respiratory system are among the main problems of premature patients in the neonatal intensive care unit. Radiography of the thorax is the gold standard of imaging. This results in high cumulative radiation exposure with potential negative long-term consequences. Ultrasound examination of thoracic structures represents a promising radiation-free and ubiquitously available alternative.

A healthy, ventilated lung can only be imaged via artifacts, since total reflection of the sound waves occurs due to the high impedance difference between tissue and air-filled lung. Pathologies of pleura and subpleural lung tissue lead to changes in the acoustic properties of the tissue and thus to variations in the artifacts that can be imaged. The main sonographic characteristics of pulmonary pathology are: pleural line abnormalities, increased B-lines and comet-tail artifacts, lung consolidations, a visible pulmonary pulse, pleural sliding abnormalities, and visualization of effusions. Deviations from normal sonographic findings can be assigned to specific underlying pathophysiologies, so that conclusions about the disease can be drawn in conjunction with the clinical symptoms.



Publication History

Article published online:
08 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Jaworska J, Buda N, Ciuca IM. et al. Ultrasound of the pleura in children, WFUMB review paper. Med Ultrason 2021; 23 (03) 339-347
  • 2 Dietrich CF, Buda N, Ciuca IM. et al. Lung ultrasound in children, WFUMB review paper (part 2). Med Ultrason 2021; 23 (04) 443-452
  • 3 Mathis G, Horn R, Morf S. et al. WFUMB position paper on reverberation artefacts in lung ultrasound: B-lines or comet-tails?. Med Ultrason 2021; 18 (01) 70-73
  • 4 Lichtenstein D. Novel approaches to ultrasonography of the lung and pleural space: where are we now?. Breathe Sheff Engl 2017; 13: 100-111
  • 5 Ammirabile A, Buonsenso D, Di Mauro A. Lung Ultrasound in Pediatrics and Neonatology: An Update. Healthcare (Basel) 2021; 9 (08) 1015
  • 6 Rea G, Sperandeo M, Di Serafino M. et al. Neonatal and pediatric thoracic ultrasonography. J Ultrasound 2019; 22 (02) 121-130
  • 7 Deeg KH, Hofmann V, Hoyer PF. Ultraschalldiagnostik in Pädiatrie und Kinderchirurgie. Stuttgart: George Thieme Verlag KG; 2014
  • 8 Lichtenstein DA, Mezière GA, Lagoueyte JF. et al. A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill. Chest 2009; 136 (04) 1014-1020
  • 9 Liu J, Copetti R, Sorantin E. et al. Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus. J Vis Exp 2019; DOI: 10.3791/58990.
  • 10 Migliaro F, Salomè S, Corsini I. et al. Neonatal lung ultrasound: From paradox to diagnosis and beyond. Early Hum 2020; 150: 105184
  • 11 Lichtenstein D, Mézière G, Biderman P. et al. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med 1997; 156 (05) 1640-1646
  • 12 Dietrich CF, Mathis G, Blaivas M. et al. Lung B-line artefacts and their use. J Thorac Dis 2016; 8 (06) 1356-1365
  • 13 Raimondi F, Yousef N, Migliaro F. et al. Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications. Pediatr Res 2021; 90 (03) 524-531
  • 14 Chen SW, Fu W, Liu J. et al Routine application of lung ultrasonography in the neonatal intensive care unit. Medicine (Baltimore) 2017; 96 (02) e5826 Published online 2017.
  • 15 Manolescu D, Davidescu L, Traila D. et al. The reliability of lung ultrasound in assessment of idiopathic pulmonary fibrosis. Clin Interv Aging 2018; 13: 437-449
  • 16 Kumar I, Siddiqui Z, Verma A. et al. Performance of semi-quantitative lung ultrasound in the assessment of disease severity in interstitial lung disease. Ann Thorac Med 2021; 16 (01) 110-117
  • 17 Cattarossi L, Copetti R, Brusa G. et al. Lung Ultrasound Diagnostic Accuracy in Neonatal Pneumothorax. Can Respir J 2016; 2016: 6515069
  • 18 Raimondi F, Rodriguez Fanjul J, Aversa S. et al. Lung Ultrasound for Diagnosing Pneumothorax in the Critically Ill Neonate. J Pediatr 2016; 175: 74-78.e71
  • 19 Soni NJ, Franco R, Velez MI. et al. Ultrasound in the Diagnosis and Management of Pleural Effusions. J Hosp Med 2015; 10: 811-816
  • 20 Kocijancic I, Vidmar K, Ivanovi-Herceg Z. Chest Sonography versus Lateral Decubitus Radiography in the Diagnosis of Small Pleural Effusions. J Clin Ultrasound 2003; 31: 69-74