WFUMB position paper on reverberation artefacts in lung ultrasound: B-lines or comet-tails?

Gebhard Mathis, Rudolf Horn, Susanne Morf, Helmut Prosch, Serena Rovida, Gino Soldati, Beatrice Hoffmann, Michael Blaivas, Christoph F. Dietrich


The analysis of vertical reverberation artefacts is an essential component of the differential diagnosis in pulmonary ultra-sound. Traditionally, they are often, but not exclusively, called B-line artefacts (BLA) and/or comet tail artefacts (CTA), but this view is misleading.

In this position paper we clarify the terminology and relation of the two lung reverberation artefacts BLA and CTA to spe-cific clinical scenarios. BLA are defined by a normal pleura line and are a typical hallmark of cardiogenic pulmonary edema after exclusion of certain pathologies including pneumonia or lung contusion, whereas CTAs show an irregular pleura line representing a variety of parenchymal lung diseases. The dual approach using low frequency transducers to determine BLA and high frequency transducer to determine the pleural surface is recommended.


lung ultrasound; artefact; B-lines; comet tails; guidelines; misdiagnosis

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