Objective: The value of transthoracic lung ultrasound in lung emphysema is not as yet known and established. The prospective study was conducted to analyzed artifacts in patients with lung emphysema by transthoracic lung sonography and compare it with computed tomography. In the second part of the work was performed experimental studies which analyzed artifacts arising in patients breathing gas mixtures containing helium. The aim of the experimental part was to present the hypothesis about the mechanism of the formation of artifacts in patients with lung emphysema.
Methods: Transthoracic lung ultrasound was performed in 14 patients with diagnosed lung emphysema (confirmed by CT scan) and in 50 control subjects (with normal X-ray and no history in the direction of lung diseases). In the experimental part, lung ultrasound examination was performed in 10 volunteers with normal history and X-Ray. While breathing a gas mixture containing helium by a set of diving, observed forming artifacts in transthoracic lung ultrasound.
Results: It has been observed previously unrecognized artifact in patients with lung emphysema, called the Am line. In patients with clinically and CT confirmed lung emphysema , reported the presence of Am lines in 100% (0% in the control group, p <0.000). In the experimental part, during the classical transthoracic ultrasound was not observed lung abnormalities. When the same volunteers breathing gas mixture containing the helium, the same artifacts as in patients with lung emphysema (Am lines) were observed (in 100% volunteers; in 0% control group; p<0,000).
Conslusions: This study indicates the possibility of the diagnosis of subpleural lung emphysema using transthoracic lung sonography.
