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OBJECTIVES: This prospective study aimed to evaluate the value of B-mode lung ultrasound (LUS) for the early diagnosis of coronavirus disease 2019 (COVID-19) infection in nonhospitalized COVID-19 suspected cases in a population with a low prevalence of disease. METHODS: From April 2020 to June 2020, in an ambulatory testing center for COVID-19-suspected cases, 297 subjects were examined by LUS before a nasopharyngeal swab was taken for a reverse transcription polymerase chain reaction (RT-PCR) test. The following LUS findings were defined as pathological ultrasound findings and were analyzed: the presence of 1) pleural effusion, 2) B-lines, 3) fragmented visceral pleura, 4) consolidation, and 5) air bronchogram in the consolidation. The LUS findings were compared with the RT-PCR test results. RESULTS: The result of the RT-PCR test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive in 11 and negative in 286 subjects, and the prevalence of COVID-19 infection in the study participants was 3.7%. On LUS, a pathological finding could be detected in 56/297 (18.9%) study participants. The LUS revealed a sensitivity of 27.3%, a specificity of 81.5%, a positive predictive value of 5.4%, a negative predictive value of 96.7%, and a diagnostic accuracy of 79.9% for the identification of COVID-19 infection. CONCLUSIONS: For the identification of COVID-19 infection, LUS is highly sensitive to the patient spectrum and to the prevalence of the disease. Due to the low diagnostic performance in nonhospitalized COVID-19 cases in low-prevalence areas, LUS cannot be considered to be an adequate method for making a diagnosis in this group.

B-mode ultrasound (B-US) is the standard imaging modality to evaluate pleural effusion. The value of B-US for assessing the malignancy of a pleural effusion (PE) is limited. For this purpose, computed tomography (CT) and thoracoscopy are the methods of choice to evaluate an effusion. The aim of this Pictorial Essay is to demonstrate contrast-enhanced ultrasound (CEUS) as a method in addition to B-US and CT for the evaluation of PE taking into account the clinical background. The characteristic patterns of pleural pathologies, effusion morphology, and associated lung parenchymal consolidations are presented.

Here, we describe the appearance and pattern of pulmonary lymphoma on B-mode imaging and with contrast-enhanced ultrasound (CEUS). From July 2009 to December 2015, 6 patients with histologically or cytologically confirmed lymphoma of the lung were examined by B-mode imaging, followed by CEUS. A retrospective analysis of the imaging data was performed with respect to the time to enhancement, pulmonary artery (PA) and bronchial artery, echogenicity (hypoechoic, isoechoic, or hyperechoic), and homogeneity (homogeneous or inhomogeneous) of the contrast enhancement. On B-mode imaging, all 6 pulmonary lymphoma lesions were hypoechoic. Five cases had PA enhancement, and 1 case had bronchial artery enhancement on CEUS imaging. Strikingly, all 6 patients had isoechoic arterial contrast enhancement. In the parenchymal phase, 3 of the lymphoma lesions showed hypoechoic contrast enhancement, and 3 showed isoechoic enhancement. Pulmonary lymphomas are hypoechoic on B-mode imaging. With CEUS, all patients had predominant PA contrast enhancement in the arterial phase with variable parenchymal contrast enhancement. Thus, definite differentiation from other malignant or benign pulmonary lesions cannot be achieved by CEUS.