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Module title = Tutorial: Lung Ultrasound
Lesson title = Interstitial Lung Patterns
This is lesson 8 of 8 in this module
Interstitial Lung Patterns
So far we have studied the following features of lung ultrasound:
lung sliding
A lines
B lines
comet tails
Memorize the following facts:
lung sliding is absent if there is:
a pneumothorax
no lung movement (stuck to chest wall or severely consolidated)
A lines are:
normal
present in pneumothorax
B lines are:
abnormal
absent with pneumothorax
B lines will obliterate A lines
B lines are caused by a "wet" visceral pleura due to:
imflammation (pneumonia, ARDS, pneuminitis)
CHF
couple other "lung" processes
Combining these findings and applying some logical thinking
, we can create some diagnostic shortcuts
1
:
Profile #1
both lungs show lung sliding, A lines, comet tails, and no B lines
this is a normal pattern
diseases that could show this pattern include COPD, asthma and pulmonary emobolism
this is called the
A profile
Profile #2
one lung shows normal pattern
one lung shows
no lung sliding
, A lines,
no comet tails, no lung pulse
and no B lines
this is unilateral pneumothorax
this is called the
A' profile
Profile #3
both lungs show lung sliding,
no A lines, no comet tails,
and
B lines
note that this is bilateral
this could be CHF, ARDS, or any bilateral inflammatory or infective process
less common cause includes pulmonary fibrosis
this is called the
B profile
Profile #4
both lungs show
no lung sliding
and
B lines
this is severe bilateral pneumonia
lung sliding is absent due to severe consolidation and no air in that lung
this is called
B' profile
Profile #5
one lung shows lung sliding, A lines, comet tails, and no B lines
other lung shows lung sliding with
B lines
this is consistent with a unilateral process such as pneumonia
this is called AB profile
References:
1 Adapted from: Soni, SJ, (2014). 'Chapter 9: Lung Ultrasound Interpretation'.
In:
(ed),
Point-of-Care Ultrasound
. 1st ed. Canada: Saunders. pp.66-67
Lesson 8 of 8
That was the last lesson!