In a new study, researchers found that lung ultrasound was highly sensitive for detecting abnormalities in patients with coronavirus disease (COVID-19), with B-lines, a thickened pleural line, and pulmonary consolidation the most commonly observed features.
The results indicate that lung ultrasound findings can be used to reflect both the infection duration and disease severity
The research was conducted by a team at Beijing Ditan Hospital in China.
From March 3 to March 30, 2020, the team performed lung ultrasound on consecutive patients with positive reverse transcriptase polymerase chain reaction (RTPCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
They compared the percentages of patients with each US finding between groups with different symptom durations and disease severity.
All 28 patients had positive findings on both lung US and chest CT.
On ultrasound, B-lines were present in 100% of patients, and 19 (67.9%) patients had pulmonary consolidation.
Thickened pleural lines were observed in 17 patients (60.7%), and only one patient (3.6%) showed a small amount of pleural effusion.
They found a thickened pleural line was more frequently observed on ultrasound in patients with longer time intervals after the initial onset of symptoms.
Pulmonary consolidations—visualized as tissuelike hypoechoic regions, reflecting highly reduced airflow and increased quantity of inflammatory cellular exudate—were more common in severe and critical cases.
The researchers found that compared to CT, ultrasound is portable, less costly, and does not use radiation.
This makes ultrasound a useful tool for triage, particularly in pre-hospital/outpatient settings, and severity stratification and monitoring, especially for critically ill patients who may be challenging to transport and require careful ventilation management.
The authors also proposed that severity scoring for lung ultrasound, similar to CT severity scores, should be developed to facilitate more accurate comparisons in future studies.
One author of the study is Yao Zhang at China’s Beijing Ditan Hospital.
The study is published in American Journal of Roentgenology (AJR).
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