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The use of lung ultrasound images for the differential diagnosis of pulmonary and cardiac interstitial pathology

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Abstract

In recent years, great advances have been made in the use of lung ultrasound to detect pulmonary edema and interstitial changes in the lung. However, it is clear that B-lines oversimplify the description of the physical phenomena associated with their presence. The artifactual images that ultrasounds provide in interstitial pulmonary pathology are merely the ultimate outcome of the complex interaction of a specific acoustic wave with a specific three-dimensional biological structure. This interaction lacks a solid physical interpretation of the acoustic signs to support it. The aim of this paper was to describe the differences between the sonographic interstitial syndrome related to lung diseases and that related to cardiogenic edema in the light of current knowledge regarding the pleural plane’s response to ultrasound waves.

Sommario

Negli ultimi anni sono stati fatti grandi progressi in ecografia polmonare per rilevare l’edema polmonare e le alterazioni dell’interstizio polmonare. Tuttavia, è chiaro che le linee B semplificano eccessivamente la descrizione di fenomeni fisici associati alla loro presenza. Le immagini di artefatti date dagli ultrasuoni nella patologia polmonare interstiziale sono soltanto il risultato finale di una complessa interazione tra un’onda acustica specifica ed una altrettanto specifica struttura biologica tridimensionale. Questa interazione manca di una solida interpretazione fisica. Lo scopo di questo lavoro è quello di descrivere le differenze ecografiche tra la sindrome interstiziale dovuta a malattia polmonare e quelle relative ad edema cardiogeno, alla luce delle attuali conoscenze in merito alla risposta del piano pleurico agli ultrasuoni.

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Authors and Affiliations

  1. UO Pronto Soccorso e Medicina d’Urgenza, Valle del Serchio General Hospital, Lucca, Italy

    Gino Soldati

  2. Department of Medical Image Processing, Fondazione Toscana Gabriele Monasterio, Pisa, Italy

    Marcello Demi

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  1. Gino Soldati
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  2. Marcello Demi
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Correspondence to Gino Soldati.

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Soldati, G., Demi, M. The use of lung ultrasound images for the differential diagnosis of pulmonary and cardiac interstitial pathology. J Ultrasound 20, 91–96 (2017). https://doi.org/10.1007/s40477-017-0244-7

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  • DOI: https://doi.org/10.1007/s40477-017-0244-7

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