Usefulness of ultrasound lung comets as a nonradiologic sign of extravascular lung water

• Published in: The American journal of cardiology 2004-05, Vol.93 (10), p.1265-1270
• Main Authors: Jambrik, Zoltan, Monti, Simonetta, Coppola, Vincenzo, Agricola, Eustachio, Mottola, Gaetano, Miniati, Massimo, Picano, Eugenio
• Format: Article
• Language: English
• Subjects: Aged; Auscultation - methods; Body fluids; Cardiology; Echocardiography; Extravascular Lung Water; Female; Humans; Lungs; Male; Point-of-Care Systems; Predictive Value of Tests; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - diagnostic imaging; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Edema - diagnosis; Pulmonary Edema - diagnostic imaging; Pulmonary Edema - physiopathology; Ultrasonic imaging
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2004.02.012

The “comet-tail” is an ultrasound sign detectable with ultrasound chest instruments; this sign consists of multiple comet-tails fanning out from the lung surface. They originate from water-thickened interlobular septa and would be ideal for nonradiologic bedside assessment of extravascular lung water. To assess the feasibility and value of ultrasonic comet signs, we studied 121 consecutive hospitalized patients (43 women and 78 men; aged 67 ± 12 years) admitted to our combined cardiology-pneumology department (including cardiac intensive care unit); the study was conducted with commercially available echocardiographic systems including a portable unit. Transducer frequencies (range 2.5 to 3.5 MHz) were used. In each patient, the right and left chest was scanned by examining predefined locations in multiple intercostal spaces. Examiners blinded to clinical diagnoses noted the presence and numbers of lung comets at each examining site. A patient lung comet score was obtained by summing the number of comets in each of the scanning spaces. Within a few minutes, patients underwent chest x-ray, with specific assessment of extravascular lung water score by 2 pneumologist-radiologists blinded to clinical and echo findings. The chest ultrasound scan was obtained in all patients (feasibility 100%). The imaging time per examination was always