Lung Ultrasound: A Leading Diagnostic Tool.

Thoracic ultrasound is an important diagnostic tool employed by many clinicians in well-defined applications [...

Lung Ultrasound Artifacts Interpreted as Pathology Footprints.

Background: The original observation that lung ultrasound provides information regarding the physical state of the organ, rather than the anatomical details related to the disease, has reinforced the idea that the observed acoustic signs represent artifacts. However, the definition of artifact does not appear adequate since pulmonary ultrasound signs have shown valuable diagnostic accuracy, which has been usefully exploited by physicians in numerous pathologies.

Method: A specific method has been used over the years to analyze lung ultrasound data and to convert artefactual information into anatomical information.

Operative Use of Thoracic Ultrasound in Respiratory Medicine: A Clinical Study.

For over 15 years, thoracic ultrasound has been applied in the evaluation of numerous lung diseases, demonstrating a variable diagnostic predictive power compared to traditional imaging techniques such as chest radiography and CT. However, in unselected pulmonary patients, there are no rigorous scientific demonstrations of the complementarity of thoracic ultrasound with traditional and standardized imaging techniques that use radiation. In this study 101 unselected pulmonary patients were evaluated blindly with ultrasound chest examinations during their hospital stay.

What Is COVID 19 Teaching Us about Pulmonary Ultrasound?

In lung ultrasound (LUS), the interactions between the acoustic pulse and the lung surface (including the pleura and a small subpleural layer of tissue) are crucial. Variations of the peripheral lung density and the subpleural alveolar shape and its configuration are typically connected to the presence of ultrasound artifacts and consolidations. COVID-19 pneumonia can give rise to a variety of pathological pulmonary changes ranging from mild diffuse alveolar damage (DAD) to severe acute respiratory distress syndrome (ARDS), characterized by peripheral bilateral patchy lung involvement.

Vertical Artifacts in Lung Ultrasonography: Some Common Clinician Questions and the Related Engineer Answers.

Introduction: Vertical artifacts, including B lines, are frequently seen in a variety of lung diseases. Their sonomorphology varies in length, width, shape, and internal reverberations. The reason for this diversity is still unknown and is the cause of discussion between clinicians and ultrasound physics engineers.

The impact of multiple concurrent factors on the length of the ultrasound pulmonary vertical artifacts as illustrated through the experimental and numerical analysis of simple models.

Nowadays, the diagnostic value of the artefactual information provided by lung ultrasound images is widely recognized by physicians. By carefully observing each individual artifact, an expert physician can derive important information on the distribution of the aerated spaces at the pleural level and, consequently, on the nature of the pulmonary disease. In this paper, a specific visual characteristic of the vertical artifacts (their length) is addressed.

On the Replica of US Pulmonary Artifacts by Means of Physical Models.

Currently, the diagnostic value of the artefactual information provided by lung ultrasound images is widely recognized by physicians. In particular, the existence of a correlation between the visual characteristics of the vertical artifacts, which arise from the pleura line, and the genesis (pneumogenic or cardiogenic) of a pulmonary disorder is commonly accepted. Physicians distinguish vertical artifacts from vertical artifacts which extend to the bottom of the screen (B-lines) and common vertical artifacts from well-structured artifacts (modulated B-lines).

Clinical Impact of Vertical Artifacts Changing with Frequency in Lung Ultrasound.

Background: This study concerns the application of lung ultrasound (LUS) for the evaluation of the significance of vertical artifact changes with frequency and pleural line abnormalities in differentiating pulmonary edema from pulmonary fibrosis.

Study Design And Methods: The study was designed as a diagnostic test. Having qualified patients for the study, an ultrasound examination was performed, consistent with a predetermined protocol, and employing convex and linear transducers.

Real-time multi-frequency ultrasound imaging for quantitative lung ultrasound - first clinical results.

Lung ultrasound imaging is a fast-evolving field of application for ultrasound technologies. However, most diagnoses are currently performed with imaging protocols that assume a quasi-homogeneous speed of sound in the volume of interest. When applied to the lung, due to the presence of air, this assumption is unrealistic.

Quantitative Lung Ultrasound Spectroscopy Applied to the Diagnosis of Pulmonary Fibrosis: The First Clinical Study.

The application of ultrasound imaging to the diagnosis of lung diseases is nowadays receiving growing interest. However, lung ultrasound (LUS) is mainly limited to the analysis of imaging artifacts, such as B-lines, which correlate with a wide variety of diseases. Therefore, the results of LUS investigations remain qualitative and subjective, and specificity is obviously suboptimal.

Physical Mechanisms Providing Clinical Information From Ultrasound Lung Images: Hypotheses and Early Confirmations.

In standard B mode imaging, a set of ultrasound pulses is used to reconstruct a 2-D image even though some of the assumptions needed to do this are not fully satisfied. For this reason, ultrasound medical images show numerous artifacts which physicians recognize and evaluate as part of their diagnosis since even one artifact can provide clinical information. Understanding the physical mechanisms at the basis of the formation of an artifact is important to identify the physiopathological state of the biological medium which generated the artifact.

The role of ultrasound lung artifacts in the diagnosis of respiratory diseases.

Thoracic ultrasound is employed for the diagnosis of many thoracic diseases and is an accepted detection tool of pleural effusions, atelectasis, pneumothorax, and pneumonia. However, the use of ultrasound for the evaluation of parenchymal lung disease, when the organ is still aerated, is a relatively new application. Areas covered: The diagnosis of a normal lung and the differentiation between a normally aerated lung and a lung with interstitial pathology is based on the interpretation of ultrasound artifacts universally known as A and B-Lines.

Determination of a potential quantitative measure of the state of the lung using lung ultrasound spectroscopy.

B-lines are ultrasound-imaging artifacts, which correlate with several lung-pathologies. However, their understanding and characterization is still largely incomplete. To further study B-lines, lung-phantoms were developed by trapping a layer of microbubbles in tissue-mimicking gel.

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

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.

Contour Tracking with a Spatio-Temporal Intensity Moment.

Standard edge detection operators such as the Laplacian of Gaussian and the gradient of Gaussian can be used to track contours in image sequences. When using edge operators, a contour, which is determined on a frame of the sequence, is simply used as a starting contour to locate the nearest contour on the subsequent frame. However, the strategy used to look for the nearest edge points may not work when tracking contours of non isolated gray level discontinuities.

Integrating mindfulness with parent training: effects of the Mindfulness-Enhanced Strengthening Families Program.

There is growing support for the efficacy of mindfulness training with parents as an intervention technique to improve parenting skills and reduce risk for youth problem behaviors. The evidence, however, has been limited to small scale studies, many with methodological shortcomings. This study sought to integrate mindfulness training with parents into the Strengthening Families Program: For Parents and Youth 10-14 (SFP 10-14), an empirically-validated family-based preventive intervention.

Ultrasonography in lung pathologies: new perspectives.

Background: Nowadays, ultrasound techniques have not gained importance in the diagnosis and monitoring of lung pathologies yet because of the high mismatch in acoustic impedance between air and intercostal tissues. However, it is evident that B-mode imaging provides important information on pulmonary tissue, although in the form of image artifacts.

Findings: Notwithstanding medical evidences, there exists no ultrasound-based method dedicated to the lung, hampering de facto the full exploitation of ultrasound potentials.

Evaluation of bilirubin concentration in hemolysed samples, is it really impossible? The altitude-curve cartography approach to interfered assays.

Background: Neonatal jaundice might lead to severe clinical consequences. Measurement of bilirubin in samples is interfered by hemolysis. Over a method-depending cut-off value of measured hemolysis, bilirubin value is not accepted and a new sample is required for evaluation although this is not always possible, especially with newborns and cachectic oncological patients.

Comparison of two automatic methods for the assessment of brachial artery flow-mediated dilation.

Objectives: Brachial artery flow-mediated dilation (FMD) is associated with risk factors providing information on cardiovascular prognosis. Despite the large effort to standardize the methodology, the FMD examination is still characterized by problems of reproducibility and reliability that can be partially overcome with the use of automatic systems. We developed real-time software for the assessment of brachial FMD (FMD Studio, Institute of Clinical Physiology, Pisa, Italy) from ultrasound images.

Assessment of carotid stiffness and intima-media thickness from ultrasound data: comparison between two methods.

Objective: Increased arterial stiffness and carotid intima-media thickness (IMT) are considered independent predictors of cardiovascular events. The aim of this study was to compare a system recently developed in our laboratory for automatic assessment of these parameters from ultrasound image sequences to a reference radio frequency (RF) echo-tracking system.

Methods: Common carotid artery scans of 21 patients with cardiovascular risk factors and 12 healthy volunteers were analyzed by both devices for the assessment of diameter (D), IMT, and distension (DeltaD).

Real-time measurement system for evaluation of the carotid intima-media thickness with a robust edge operator.

Objective: The purpose of this report is to describe an automatic real-time system for evaluation of the carotid intima-media thickness (CIMT) characterized by 3 main features: minimal interobserver and intraobserver variability, real-time capabilities, and great robustness against noise.

Methods: One hundred fifty carotid B-mode ultrasound images were used to validate the system. Two skilled operators were involved in the analysis.

Ultrasound measurement of the brachial artery flow-mediated dilation without ECG gating.

The methods commonly used for noninvasive ultrasound assessment of endothelium-dependent flow-mediated dilation (FMD) require an electrocardiogram (ECG) signal to synchronize the measurements with the cardiac cycle. In this article, we present a method for assessing FMD that does not require ECG gating. The approach is based on temporal filtering of the diameter-time curve, which is obtained by means of a B-mode image processing system.

Real-time measurement system for the evaluation of the intima media thickness with a new edge detector.

The evaluation of the intima media thickness (IMT) of the common carotid artery (CCA) with B-mode ultrasonography represents an important index of cardiovascular risk. The IMT is defined as the distance between the leading edge of the lumen-intima interface and the leading edge of the media-adventitia interface. In order to evaluate the IMT, it is necessary to locate such edges.