Assessment of ultrasound acoustic artifacts in patients with acute dyspnea: a multicenter study.
BACKGROUND
Recent reports indicate that numerical assessment of B-lines during transthoracic ultrasound may aid the differential diagnosis of acute diffuse pleuropulmonary disorders.


OBJECTIVE
To determine whether B-lines are different in normal and diseased lungs and whether they can be used to discriminate between different types of pulmonary disorders in acutely ill patients.


METHODS
In this multicenter study, transthoracic ultrasonography was performed on 193 patients with acute dyspnea, 193 healthy non-smokers, and 58 patients who had undergone pneumonectomy for lung cancer. Examinations were done with a low-medium frequency (3.5-5.0 MHz) convex probe and a high-frequency (8-12.5 MHz) linear probe. Video recordings were re-examined by a second set of examiners. In each participant, we measured the number of B-lines observed per scan.


RESULTS
B-lines counts were higher in dyspnoic patients (means: 3.11 per scan per linear probe scan vs. 1.93 in healthy controls and 1.86 in pneumonectomized patients; P < 0.001 for all); all counts were higher when convex probes were used (5.4 in dyspnoic patients and 2 in healthy controls; P < 0.001 vs. the linear probe). Subgroups of dyspnoic patients defined by cause of dyspnea displayed no significant differences in the number of B-lines.


CONCLUSIONS
Our results demonstrate that there are a significant higher number of B-lines in the lungs of patients with dyspnea compared to healthy subjects and to pneumonectomized patients. Nevertheless, the quantification of B-lines does not make any significant contribution to the differential diagnosis of dyspnea.
Unit of Internal Medicine, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Foggia, Italy.
Marco
M
Sperandeo
Antonio
A
Varriale
Giuseppe
G
Sperandeo
Eva
E
Polverino
Beatrice
B
Feragalli
Maria Luisa
ML
Piattelli
Michele M
MM
Maggi
Vincenzo O
VO
Palmieri
Fulvia
F
Terracciano
Ilario
I
De Sio
Massimo
M
Villella
Massimiliano
M
Copetti
Fabio
F
Pellegrini
Gianluigi
G
Vendemiale
Cristiana
C
Cipriani
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D055815:Young Adult