Analysis on characteristics of lung ultrasound images of common lung diseases in newborns

FENG Zaili; YANG Mingjie; HUANG Na; ZHANG Meiling; XU Fang; DUAN Shengluan; LI Rui; GUO Yunhua

doi:10.3969/j.issn.1674-3806.2025.04.12

Abstract：Objective To analyze the characteristics of lung ultrasound(LUS)images of common lung diseases in newborns.Methods A total of 466 newborns with suspected lung diseases who were born in Dehong Hospital Affiliated to Kunming Medical University(Dehong Prefecture People's Hospital)from March 2018 to January 2024 were recruited.The newborns received both chest X-ray examination and LUS examination,with the time interval between the two examinations equal to or less than 15 minutes.Based on clinical manifestations,the diagnostic results of the two examinations were consistent.The characteristics of LUS images in different types of newborns were concluded and summarized.Results Among the 466 newborns,there were 88 cases of transient tachypnea of newborn(TTN),69 cases of neonatal respiratory distress syndrome(NRDS),29 cases of neonatal acute respiratory distress syndrome(ARDS),57 cases of meconium aspiration syndrome(MAS),89 cases of neonatal pneumonia(NP),6 cases of neonatal pulmonary hemorrhage(NPH),20 cases of bronchopulmonary dysplasia(BPD),3 cases of neonatal pulmonary atelectasis,8 cases of neonatal pneumothorax,and 97 case of non-pulmonary diseases.The characteristics of LUS images of normal lungs in newborns:no abnormalities in pleural line and A-line,presence of lung slippage;manifestation of beach sign in M-mode ultrasound;absence of alveolar-interstitial syndrome(AIS),dense B-line,white lung and lung consolidation;possible B-line/comet-tail sign.The characteristics of LUS images of TTN:having abnormality in pleural line,abnormality in A-line,beach sign;having one or more than one feature of AIS/dense B-line/white lung,bipulmonary dots,B-line/comet-tail sign;possible lung islands and pleural effusion.The characteristics of LUS images of NRDS,ARDS,MAS,NP,NPH and BPD:having one of the manifestations of lung consolidation,fragment sign,ground-glass sign,snowflake sign,pulmonary pulsation and beach sign,and having the possible features of B-line/comet-tail sign,AIS/dense B-line/white lung,bipulmonary dots,abnormality in pleural line,abnormality in A-line and pleural effusion;and having the common manifestation of lung consolidation in LUS images.The LUS images of neonatal pulmonary atelectasis were manifested as lung consolidation,but no bipulmonary dots and pleural effusion were observed.The characteristics of LUS images of neonatal pneumothorax:presence of abnormality in lung slippage,stratosphere sign and possible bipulmonary dots.Conclusion LUS can be used for the examination and diagnosis of common lung diseases in newborns.However,the same disease may have multiple characteristics of ultrasound images simultaneously,and the same characteristics of ultrasound images may also indicate different diseases.Clinicians should make the diagnosis for the newborn patients based on their clinical manifestations in combination with other examination results.