Case

A lines vs Coalescent B Lines

Case of twins that were born extremely preterm. A lung ultrasound was performed at 36 weeks PMA. Baby A was at this point in room air. Baby B was in CPAP + 6 with FiO2 requirement of 30%. 

Twin A

One may appreciate the nice A lines (linear reflections of the pleura) in the right upper lobe, outlining nice aeration of this lobe of the lungs. 

A-lines (linear reflections of the pleura) in the right lower lobe are visible, and lung sliding is observed. As the probe is moved caudally, the liver also becomes visible. 

M-mode demonstrating the classic "Sand on the Beach" or "Seashore" sign, indicating there is no pneumothorax. Due to the presence of A-lines, the lower field of the M-mode includes linear streaks corresponding to these A-lines.

Twin B

Coalescent B-lines are observed in the right upper lobe in this baby who has bronchopulmonary dysplasia (BPD) and oxygen requirements. This indicates that the lung is congested and may have interstitial fluid, typical in cases of BPD.

Coalescent B-lines are observed in the right lower lobe. We can also appreciate some of the liver as we slide caudally.


M-mode demonstrating the classic "Sand on the Beach" or "Seashore" sign, indicating there is no pneumothorax. 

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