Figure 4

Lung consolidation. Two signs of lung consolidation. Left: a massive consolidation (probe at the PLAPS-point) invades the whole left lower lobe. No aerated lung tissue is present, and no fractal sign can be generated. The deep border is at the mediastinal line (arrows). The pattern is tissue-like, similar to the spleen (S). The thickness of this image is roughly 10 cm, a value incompatible with a pleural effusion. Image acquired using an ADR-4000 and a sectorial probe (1982 mobile technology) Right: a middle lobe consolidation, which does not invade the whole lobe. This generates a shredded, fractal boundary between the consolidation and the underlying aerated lung (arrows): the quite specific shred (or fractal) sign. Such an anterior consolidation generates the C-profile in the BLUE-protocol. Compare with the regular lung line of Figure 3. Note the blurred letters due to multiple transfers of this image. Quantitative data: a reasonable thickness at the right image is 5.5 cm, giving an index of 5.5 corresponding to a 165-mL consolidation, roughly. In the left image, the 10-cm depth would correspond to a volume of roughly 1 L. Adapted from “Whole body ultrasonography in the critically ill” (2010 Ed, Chapter 16), with kind permission of Springer Science.