FIGURE LEGENDS
FIGURE 1. Grayscale lung ultrasound examination (linear probe, 12 MHz, and the small parts preset) shows Septal Pattern of early CPE (8) in a 14-year-old boy with acute heart failure caused by non-diagnostic and untreated rheumatic carditis (A and B) and in a 5-year-old girl with systemic inflammatory disease in course of sepsis in the absence of functional and / or organic alteration of the myocardium (C, D and E).
Figures A and B show the SIS pattern of the posterior basal right and left fields respectively; those C, D and E show that of the posterior basal left and right fields (C and D) and lateral basal right (E) respectively.
The pleural line is regular (arrowhead). There are no short vertical artifacts and subpleural consolidations. B-lines or long vertical artifacts (arrows) are multiple, and separated / non-confluent, laser like artefacts, with gravitational course spreading from the pleural line to the bottom of the screen and they show an internal sequence of alternating horizontal bands. They are distributed homogeneously in the explored fields ”without spared areas”.
CPE, cardiogenic pulmonary edema; SIS, sonographic interstitial syndrome.
FIGURE 2. Grayscale lung ultrasound examination (linear probe, 12 MHz, and the small parts preset) in a child of 14 months with viral lower respiratory tract infection caused by RSV and Bocavirus. The figures above and below show the SIS pattern located on the upper and lower fields respectively of the left posterior lung fields.
The pleural line is irregular. There are small subpleural consolidations (hypoechoic areas, arrows) and below areas of white are evident (arrowheads). B-lines or long vertical artifacts are multiple and confluent; they do not have a gravitational trend and do not have a laser arefacts-like appearance; they create areas of white lung (arrowheads) and are unevenly distributed in the explored fields.
RSV, Respiratory Syncytial Virus; SIS, sonographic interstitial syndrome.
FIGURE 3. Grayscale lung ultrasound examination (linear probe, 12 MHz, and the small parts preset) shows a SIS picture in a completely healthy infant.
Figures A and B show the SIS pattern of the left anterior upper and lower fields respectively; those C, D show that of the upper posterior left and upper lateral left fields respectively.
The pleural line is regular (arrowheads) with no subpleural consolidations. Figures B and D show short vertical artifacts (black arrows). B-lines or long vertical artifacts (withe arrows) are single and separated / non-confluent in figures A and B, while in figures C and D they are multiple and tend to merge. They are distributed unevenly ”with spared areas” where a normal ultrasound pattern with A lines (asteristisks) is clearly visible.
SIS, sonographic interstitial syndrome.