Lung Ultrasound

Welcome to the Siemens ultrasound COVID-19 review. In this presentation we will look at COVID-19 clinical impact. Lung ultrasound. Artifacts associated with lung ultrasound. And presets that may be used on Siemens ultrasound systems. Coronavirus disease 2019 or COVID-19, is a viral disease that causes severe acute respiratory distress. It is also referred to as severe acute respiratory syndrome coronavirus 2. Symptoms are fever, dry cough, fatigue and shortness of breath. Cases can progress to new Monia and multi organ failure. Ultrasound of the lung is a fairly new exam. With the high acoustic mismatch between soft tissue and air, we cannot typically image the lung due to total reflection of the ultrasound beam. In recent years, clinicians found that there are different pathologies that may cause ultrasound artifacts. That may help diagnose different lung conditions. COVID-19 tends to affect the terminal alveolae in the peripheral area of the lung. Lesions tend to be close to the pleura, which is exactly where ultrasound works best. Ultrasound findings in the lung may include thickened, irregular plural line or broken glass appearance. Be lines which may be single, multiple or confluence. Consolidation or solidification of lung tissue. Replacement of air with tissue and or fluid. Pleural effusion, which is not prevalent with COVID-19 or viral pneumonia, may be seen in other conditions. The lung may be scanned in eight zones. Some clinicians expand to 12 zones, which will include posterior scanning, if possible, with patients that are critically ill and unable to sit up or roll over the eight zone method is preferred. There are three transducer types available to scan the lung. The curved array phased array and linear array transducers. The curved array is the preferred transducer for scanning the lung. The image quality is high enough to visualize the pleural lining that can also penetrate to show consolidations and effusions. The phased array transducer is a multi-purpose transducer commonly used for emergency, an intensive care units to perform cardiac lung, an fast exams. It may be difficult to visualize the pleural lining with this transducer, however, this transducer penetrates well to demonstrate consolidations and effusions. The linear transducer is preferred to evaluate superficial structures, and the pleural lining. Airlines are reverberation artifacts seen as horizontal lines, intermittently spaced reflecting off of the strong pleural lining, bright white horizontal lines will be displayed in evenly spaced intervals from top to bottom of the image. Airlines are seen with an aerated, healthy lung. Felines are artifacts seen when there is too much fluid in the lung. One or two beelines may not be concerning, but when they increase in number or spread out in one zone, they may be an indication of lung interstitial syndrome. Bright white linear lines from lung plural to bottom of the image may be seen. Beelines obscur airlines. Pneumothorax is a condition where the visceral and parietal layers of the lung are compromised and air collects in the pleural space between the lung and chest. This is also known as a collapsed lung. Ultrasound findings include absence of sliding scene with respiration at the pleural lining, absence of lung pulse is also an indication of pneumothorax. On this slide, imaging with the Acuson Juniper, we are able to visualize be Lions Anna small consolidation. Above. Are images of the lung imaged using the acuson P500 ultrasound system? The CH5 2AN L 10 Five V were used. Here we have image so long using the acuson freestyle ultrasound system, the L83 and C5 two transducers were used. Scanning the lung with the acuson Juniper is very easy as the system is ready to go the acuson Juniper is a system that was designed for emergency Department critical care and intensive care units. This system features preconfigured long and fast presets on each transducer. Slight adjustments for customer preference can be made and saved. Here we have the recommended preset for scanning the lung on the P500 lung. Ultrasound uses artifacts to help diagnose and manage patients. Many of the advanced features such as com, pounding, special reduction, an harmonics interfere or mask these artifacts. Deactivating these features for this preset is critical for the curved and phased array probes, depth should be set at or around 14 centimeters. Decreased dynamic range to increase contrast and deactivate THI or tissue harmonic imaging. Advanced see clear and DTC E. Then create a preset specifically for lung. For the linear transducer, depth should be set to 8 centimeters. Again, deactivate TH I advanced see clear DTC and create a preset for long. For the acuson freestyle system, activate the small parts preset, then set your depth at or around 12 centimeters. For the curved transducer, again decreased dynamic range to around 50. Reduce com pounding to one. Reduce speckled to one and set the post processing setting to three. Save these as a user defined preset. Repeat the same steps on the linear transducer, however, set your depth out or around 6 centimeters. Thank you for your attention.

SIEMENS SIEMENS ... ACUSON Juniper Ultrasound System - Lung Ultrasound ACUSON Freestyle Ultrasound System - Lung Ultrasound Lung Ultrasound Lung Ultrasound Transducers Lung Sliding and Lung Pulse Lung Ultrasound Presets for ACUSON P500pe Lung Ultrasound Presets for ACUSON P500 Lung Ultrasound Presets for ACUSON Freestyle Lung Ultrasound Presets for ACUSON Juniptyle Lung Ultrasound Presets for ACUSON Junipe Lung Ultrasound Presets for ACUSON Juniper Healthineers SIEMENS SIEMENS .. SIEMENS ... Less is more... SIEMENS Healthineers Healthineers Lung ultrasound uses artifacts to help diagnose and manage patients. Many of the advanced Lung Ultrasound Curved/Phased/Linear Probes Pneumothorax is a condition where the visceral and Curved Array Phased Array Linear Array COVID-19 features such as compounding, speckle reduction and harmonics interfere or mask these artifacts. parietal layers of the lung are compromised and air Turning these off for this preset is critical. collects in the pleural space between the lung and Multi-purpose transducer •Preferred transducer tor •Preferred transducer for 1.3 chest wall. This is also known as a collapsed lung. Curved/Phased Probes Curved Array Linear Array Curved Probes Curved Array Linear Probes Linear Array Lung Ultrasound SIEMENS . SIEMENS lung scanning for ED and ICU units to do evaluate superficial lung Diagnosis methods may include CT, Xray or lung Lung Ultrasound cardiac, FAST and lung surfaces and pleural lining ultrasound. Depth should be set ato 14 cm Depth should be set ato14 8cm Depth should be set at 14 cm Depth should be set to 8cm Siemens Presets Presets •IQ good enough to visualize scanning Artifacts Ultrasound findings: Decrease Dynamic Range (around 65) Decrease Dynamic Range (around 65) Healthineers COVID-19 pleural lining and still Decrease Dynamic Range (around 65) Decrease Dynamic Range (around 65) •Decrease Dynamic Range to 50 Clinical findings: Ultrasound findings: Difficult to see pleural penetrate to see Absence of sliding seen with respiration at the Turn off: Turn off: Presets consolidations and effusions lining well but can pleural lining (bright white interface surrounding •THI •THI penetrate to see lungs) lung •Adv Sie Clear •Adv Sie Clear Absence of lung pulse (when scanning and holding •DTCE .DTCE consolidations and .DTCE •DTCE still, you will see a pulse movement at the pleural lung effusions lining. This will be absent with pneumothorax) Create customized preset under EM Create customized preset under EM