Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (20)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Agricola, E.
Right arrow Articles by Picano, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Agricola, E.
Right arrow Articles by Picano, E.
(Chest. 2005;127:1690-1695.)
© 2005 American College of Chest Physicians

"Ultrasound Comet-Tail Images": A Marker Of Pulmonary Edema*

A Comparative Study With Wedge Pressure And Extravascular Lung Water

Eustachio Agricola, MD; Tiziana Bove, MD; Michele Oppizzi, MD; Giovanni Marino, MD; Alberto Zangrillo, MD; Alberto Margonato, MD and Eugenio Picano, MD

* From the Divisions of Non-Invasive Cardiology (Drs. Agricola, Oppizzi, and Margonato) and Anesthesiology and Intensive Care (Drs. Bove, Marino, and Zangrillo), Cardiothoracic Department, San Raffaele Hospital, Istituto di Richerche e Cura a carattere Scientifico, Milano; and Institute of Clinical Physiology (Dr. Picano), Consiglio Nazionale delle Richerche, Pisa, Italy.

Correspondence to: Eustachio Agricola, MD, Division of Non-Invasive Cardiology, Cardiothoracic Department, San Raffaele Hospital, IRCCS, Via Olgettina 60, 20132 Milano, Italy; e-mail: agricola.eustachio{at}hsr.it

Background: Echographic examination of the lung surface may reveal multiple "comet-tail images" originating from water-thickened interlobular septa. These images could be useful for noninvasive assessment of interstitial pulmonary edema.

Study objective: The purpose of this study was to assess the diagnostic accuracy of lung comet-tail images compared with chest radiography, wedge pressure, and extravascular lung water (EVLW) quantified by the indicator dilution method (PiCCO System, version 4.1; Pulsion Medical Systems; Munich, Germany).

Methods and patients: We enrolled 20 patients (mean age, 62.6 ± 11.5 years [± SD]). Patients were studied before, immediately after, and 24 h following cardiac surgery with chest ultrasound, chest radiography, pulmonary artery catheterization, and the PiCCO system. Performing echo scanning (right and left hemithorax, from second to fourth intercostal space, from parasternal to midaxillary line), an individual patient comet score was obtained by summing the number of comets in each scanned space.

Results: A total of 60 comparisons were obtained. Significant positive linear correlations were found between comet score and EVLW determined by the PiCCO System (r = 0.42, p = 0.001), between comet score and wedge pressure (r = 0.48, p = 0.01), and between comet score and radiologic lung water score (r = 0.60, p = 0.0001).

Conclusions: The presence and the number of comet-tail images provide reliable information on interstitial pulmonary edema. Therefore, ultrasonography represent an attractive, easy-to-use, bedside diagnostic tool for assessing cardiac function and pulmonary congestion.

Key Words: alveolar interstitial syndrome • chest ultrasound • comet-tail artifact • extravascular lung water




This article has been cited by other articles:


Home page
 JAMAHome page
P. J. Fagenholz and N. S. Harris
High-Altitude Pulmonary Edema and Patent Foramen Ovale
JAMA, April 4, 2007; 297(13): 1432 - 1432.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2005 by the American College of Chest Physicians.