Lung Ultrasound

What it does

Lung Ultrasound reads the short clips a bedside physician records over the chest of a breathless or ventilated patient: one clip of three to six seconds per zone, at the BLUE points or over a 12-zone scheme, often from a handheld probe. Unlike most ultrasound, the lung exam reads artefacts rather than anatomy: A-lines, B-lines, the pleural line and its sliding.

The run returns a per-zone table (A pattern, B pattern, consolidation, effusion, sliding), combines the zones into a BLUE-protocol profile, and scores aeration zone by zone into a total LUS score. Together the sections address the time-critical questions: pneumothorax, cardiogenic pulmonary oedema or interstitial syndrome, pneumonia and pleural effusion.

Intended use

Decision support for emergency and intensive-care physicians who scan and interpret their own lung clips, and a documented second read for the residents and nurses learning point-of-care lung ultrasound. Subcutaneous emphysema, bullae and pleurodesis can mimic pneumothorax, so the pneumothorax result is a probability backed by the sliding, lung-pulse and lung-point evidence.

Who it is for

Emergency physicians, intensivists, anaesthesiologists, pulmonologists, hospitalists and POCUS educators. Developers add the run to handheld-ultrasound apps, ICU charting and teleultrasound review.

Accepted input

• Zone clips: B-mode cine, one clip per zone, as DICOM Ultrasound Multi-frame objects or MP4/MOV exports from handheld devices.
• M-mode strips: optional, through the pleural line, to support the sliding decision.
• Zone labels: zone names typed on screen are read as metadata; clips are also classified by appearance.

Requirements

Requirement	Why
Cine, not stills	Sliding, lung pulse and B-line movement exist only over time; still images are refused for pneumothorax
3 to 6 seconds per clip	At least one full respiratory cycle at the pleural line
Anterior zones on both sides	Pneumothorax is assessed on the anterior chest
Posterolateral (PLAPS) clips	Effusion and dependent consolidation are found there
12 zones for the LUS score	The 0–36 total needs every zone scored

The interpleural distance and the consolidation size need a calibrated or readable depth scale; without one, these sections return the pattern without a size.

Optional context

The clinical question (dyspnoea, suspected pneumothorax, monitoring of aeration), ventilation status and age go in clinical_context.

The result

One JSON result in sections with a per-zone table, findings, measurements and scores, plus B-line masks and overlay clips. A zone without a visible pleural line returns "insufficient view" rather than a pattern.

Section	Content
B-lines	Presence and count per zone (0, 1–2, 3 or more, confluent), percentage of the intercostal space, location
Pneumothorax	Lung sliding present or absent, lung pulse, B-lines, lung point and a pneumothorax probability
Consolidation	Tissue-like pattern (hepatisation), shred sign, dynamic air bronchogram and size
Pleural effusion	Presence, simple or complex appearance, interpleural distance and a volume estimate
LUS aeration score	Aeration score 0–3 for each of 12 zones and the total from 0 to 36
Draft report	Opt-in (options.report): an English narrative that interprets the result for the reader (findings, impression, limitations); every number is checked against the findings

Standards

• Protocols: BLUE protocol (Lichtenstein 2008) for the zone profile; international evidence-based recommendations for point-of-care lung ultrasound (2012) and their 2025 focused update for terms and findings.
• Scoring: standardised lung ultrasound score (Soldati 2020), 0 to 3 per zone.
• DICOM: SR Measurement Report TID 1500; Parametric Map for B-line density; SEG for artefact masks; MP4 overlays.

Scoring notes

Each zone scores from 0 (normal aeration) to 3 (severe loss of aeration), and the 12 zone scores add up to the 0–36 total. B-line counts change with preset (harmonics, focus, depth) and probe, so repeat scores of a ventilated patient compare best on the same device and settings.

Related models

• us/echo (focused section) and us/vascular (DVT) complete the breathless-patient work-up.
• us/fast uses the same pneumothorax read in trauma.