Chest ultrasound in neonates: What neonatologists should know

Figure 1 Pleural line and A-lines in normal lung. The A-lines (red arrows) are horizontal artifactual repetitions of the pleural line (yellow lines) displayed at regular intervals.

Figure 2 Bat sign created by the pleural line and ribs on either side. This view represents a normal lung surface, where the bright lateral line is the visceral and parietal interface, and the dark “bat wings” are rib shadows.

Figure 3 Lung sliding and a shimmering appearance of the pleura. Lung sliding refers to a to-and-fro movement of the visceral pleura in contact with the parietal pleura due to shimmering/glimmering (or twinkling) of the pleural line on 2-Dimensional ultrasound.

Figure 4 M-mode of the normal lung shows “Sand on the Beach” appearance or Seashore sign. The movement of the lung during respiration creates a speckled appearance like grains of sand (the shore) beneath the bright pleural line (Yellow arrow). In contrast, the soft tissues (Subcutaneous fat tissues) above the pleural line do not move with respiration and do not change with time and thus have a linear appearance (Sea appearance).

Figure 5  Dynamic air bronchogram.