B-Line Artifact as a Diagnostic Tool in Various Conditions at the Emergency Department

Abstract

BACKGROUND: B-line artifacts (BLAs) play an important role in identifying lung pathology. They may indicate different diseases. However, the diagnostic study of BLA as applied to emergency patients has not been well studied. AIM: The aim of this study was to determine the diagnostic accuracy of BLA in various conditions. METHODS: This was a retrospective observational study of emergency patients who had received lung ultrasound at Srinagarind Hospital’s Emergency Department throughout January 2020–December 2020. Ultrasound artifacts were recorded. Ultrasonography findings were correlated with final diagnosis. Sensitivity and specificity were also calculated. RESULTS: A total of 105 patients were evaluated. The most prevalent condition which BLA found in this study was pulmonary edema (44.12%) with 88.24% sensitivity and 46.48% specificity. BLA also indicated pneumonia with 66.67% sensitivity and 35.71% specificity. Diffuse BLA indicated pulmonary edema with 70% sensitivity and 70.42% specificity. Focal BLA indicated pneumonia with 28.57% sensitivity and 76.19% specificity. CONCLUSIONS: The sensitivity of BLA for pulmonary edema and pneumonia diagnosis in this study was of moderate to good sensitivity, but low specificity. BLA may become crucial in the diagnosis of lung pathology in the emergency department.

Targeted management of evolving and established chronic lung disease of prematurity assisted by cardiopulmonary ultrasound: A case report of four patients

“…Studies enrolling adult patients prove that LUS may be a valuable aid in providing differential diagnoses for interstitial diseases ( 23 , 24 ). In particular, B-lines due to pulmonary fibrosis/inflammation generally start at the posterior lung basis and are often associated with irregularities of the pleural line and subpleural small consolidations ( 25 ).…”

Use of Cardio-Pulmonary Ultrasound in the Neonatal Intensive Care Unit

“…In adult patients, the presence of B-lines has a great sensitivity in picking up pathological processes involving the interstitium, although the specificity in distinguishing the possible underlying process (i.e., pulmonary edema, pneumonia, interstitial lung disease due to fibrosis) is still debated [ 33 ]. The evaluation of the B-line’s distribution and the pleural line characteristics may increase LUS efficiency in providing differential diagnoses for interstitial diseases.…”

The diagnostic capabilities of the combined cardiac and lung point of care ultrasound in shocked patients at the emergency department – Resourced limited country

“…Several sonographic findings could be demonstrated include the left ventricle and right ventricle chamber sizes, left ventricle systolic function, the IVC, the presence of intramural mass, myocardial motion, and the presence of pericardial effusion. Another application is lung ultrasound [11] , [12] , [13] which demonstrate artifacts such as A line and B-line [14] that have been suggested to be helpful to assess volume status in hypotensive patients.…”