Experience of ultrasound application in diagnosis of sars-cov-2 pneumonia

Abstract

Purpose. To assess the possibilities of using the ultrasound method in detecting signs of pneumonia associated with COVID-19. Material and methods. The experience of using ultrasound lungs examination of 75 patients hospitalized for COVID-19. Ultrasound studies were carried out on a portable device Mindray DC-6900 (China) using linear transducers at a frequency of 5.0-15 MHz and convex transducers at a frequency of 3.5-5.0 MHz. The method of ultrasound examination of the chest organs provided for a sequential examination and assessment of twelve conventional scanning zones. The presence of artifacts of the ultrasound image along the horizontal (A-line) and confluent vertical (B-lines) scanning lines was studied. Results. Ultrasound examination of the lungs of 75 patients with COVID-19 revealed vertical artifacts of the ultrasound image. Focal or confluent B-lines (49,3% patients), as well as thickening and compaction of the pleural line (44% patients), subpleural consolidations in the form of hypoechoic areas under the pleural line (34,7% patients). Pleural effusions were found in 3 (4%) cases. In 35 (46,7%) patients with a mild course of the disease and an asymptomatic form, according to the ultrasound examination, horizontal A-lines were identified, which indicated the preservation of the airiness of the lungs. Discussion. The main ultrasound diagnostic criteria for pneumonia caused by SARSCoV-2 is the absence of horizontal A-lines and the appearance of vertical B-lines. Subpleural consolidations and changes in the pleural line served as additional ultrasound signs. Ultrasound signs and the number of affected areas correlated with the severity of the disease. False negative results were associated with deep-seated consolidations or shielding by scapulae and ribs. Significant difficulties in imaging the chest organs have arisen in obese patients. In these cases, the data of ultrasound studies in combination with X-ray and CT scan facilitated a more precise diagnosis of the course of the disease. Conclusion. Ultrasound examination is one of the available methods in the diagnosis and assessment of the severity of the disease and can be used more widely in clinical practice..