Mapping Bullous Emphysema With Lung Ultrasound: A Prospective Multicentre Study

• DOI: 10.1111/resp.70021
• Publication Date: 2025-03-11T15:46:31Z
• Authors: Kinan El Husseini; Thomas Flament; Sophie Laroumagne; Damien Basille; Mathilde Le Brun; Elise Noël‐Savina; Philippe Richard; Gilles Mangiapan; Elise Artaud‐Macari
• Keywords: Bulla (seal)

Lung ultrasound holds high diagnostic performance for pleural diseases, notably pneumothorax. Bullous emphysema is a potential differential diagnosis of pneumothorax on ultrasound, but its precise semiology poorly known. This study aimed to delineate the sonographic presentation bullous and assess common features in identifying bullae. From June 2019 2021, patients with CT scanner-confirmed were prospectively included. Investigators performed standardised 14-region lung ultrasound. Sonographic non-bullous regions compared. Diagnostic performances bullae calculated each sign, an additive score was constructed using signs specificity > 85%. Pearson's correlation used examine relationship between this score, bulla size, respiratory functional parameters. Thirty-six included, mostly male (n = 33 patients, 91.7%), average age 62 ± 11 years. Bullae affected apical 24 67%). displayed more frequent absence sliding (34% vs. 11% regions, p < 0.01), barcode sign (15% 3%, increased A-line visibility (16% 8%, 0.048), Z lines (62% 44%, 0.018). A bulla-point visualised 4% regions. Absent pulmonary distension Patient (3 [2-6]) correlated size (r 0.53 [0.25;0.73], 0.001), FEV1 -0.38 [-0.60;-0.03], 0.022), forced vital capacity [-0.64;-0.08], 0.021). Our findings challenge previous data about emphysema, highlighting need cautious interpretation clinical practice. NCT04012359.