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TRANSDUCER AND MACHINE SETTINGS 

Most Lung US artefacts originate from the pleura which is superficial. Thus, traditionally, the linear transducer (high frequency, excellent resolution superficially, poor depth penetration) has been used. However, lung disease leads to increased lung water and consolidation which allows US to penetrate into the lung tissue. In order to image lung pathology well, a greater depth penetration is required. For this reason, the current recommendation for lung US is the curvilinear transducer (low frequency, good superficial resolution and depth penetration). 

Use the CURVILINEAR transducer to image the pleura and lung parenchyma

Modern US machines have mechanisms in place to decrease artefacts in order to achieve a clearer image. Because lung US relies on imaging artefacts, some of these settings should be turned off when imaging the pleura in isolation. However, I find that when looking at the lung parenchyma, eg. consolidation, a normal abdominal setting creates better imaging.

MACHINE SETTINGS FOR PLEURA

Compound and Harmonic imaging: off

Dynamic range: decreased (increases the contrast)

Filters: off

This is the lung setting. It accentuates pleural sliding and B lines. The lung setting is not as good for consoldiation. Because, consolidation is the hepatisation of lung. This means it becomes more like a solid organ which is imaged better with the abdominal setting. 

Lung Setting imaging: note B lines become more prominent. But consolidation is less defined

Standard abdominal setting imaging

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