Emergency Radiology

, Volume 15, Issue 3, pp 145–151 | Cite as

Usefulness of lung ultrasound in the bedside distinction between pulmonary edema and exacerbation of COPD

  • Giovanni VolpicelliEmail author
  • Luciano Cardinale
  • Giorgio Garofalo
  • Andrea Veltri
Review Article


This review discusses the usefulness of bedside lung ultrasound in the diagnostic distinction between different causes of acute dyspnea in the emergency setting, particularly focusing on differential diagnosis of pulmonary edema and exacerbation of chronic obstructive pulmonary disease (COPD). This is possible using a simple unit and easy-to-acquire technique performed by radiologists and clinicians. Major advantages include bedside availability, absence of radiation, high feasibility and reproducibility, and cost efficiency. The technique is based on analysis of sonographic artifacts instead of direct visualization of pulmonary structures. Artifacts are because of interactions between water-rich structures and air and are called “comet tails” or B lines. When such artifacts are widely detected on anterolateral transthoracic lung scans, we diagnose diffuse alveolar-interstitial syndrome, which is often a sign of acute pulmonary edema. This condition rules out exacerbation of COPD as the main cause of an acute dyspnea.


Lung ultrasound Dyspnea Chest sonography Pulmonary edema Alveolar-interstitial syndrome 


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Copyright information

© Am Soc Emergency Radiol 2008

Authors and Affiliations

  • Giovanni Volpicelli
    • 1
    • 3
    Email author
  • Luciano Cardinale
    • 2
  • Giorgio Garofalo
    • 2
  • Andrea Veltri
    • 2
  1. 1.Department of Emergency MedicineUniversity of Torino, San Luigi Gonzaga HospitalOrbassano, TorinoItaly
  2. 2.Institute of RadiologyUniversity of Torino, San Luigi Gonzaga HospitalOrbassano, TorinoItaly
  3. 3.Medicina d’UrgenzaOspedale San Luigi GonzagaOrbassanoItaly

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