Estratto
Recentemente è stata proposta e applicata una metodica diagnostica basata sull’ecografia del torace, che consente una rapida diagnosi e quantificazione dell’acqua extravascolare polmonare. All’ecografia del torace, il segno indicativo di acqua extravascolare polmonare, è rappresentato dalle cosiddette “comete ultrasoniche polmonari” (o ULC, dall’inglese ultrasound lung comets). L’approccio ultrasonico può apparire contro-intuitivo, essendo noto a tutti che, come afferma anche l’edizione 2008 dell’Harrison, testo di riferimento di medicina interna, »poiché l’aria dissipa rapidamente l’energia ultrasonora, l’ecografia non è utile per la valutazione del parenchima polmonare«. È vero infatti che, in condizioni normali, l’aria nei polmoni rappresenta una cortina impenetrabile per le onde ultrasoniche. È però altrettanto vero che la situazione cambia completamente nel polmone in cui la presenza di acqua a livello dell’interstizio polmonare e negli alveoli aumenti lo spessore dei setti (normalmente al di sotto della risoluzione del fascìo ultrasonoro) o modifichi le proprietà fisiche del polmone, creando salti di impedenza acustica, che generano le comete ultrasoniche polmonari.
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Soldati, G., Gargani, L., Picano, E. (2009). Le comete ultrasoniche polmonari: un nuovo segno ecografico di acqua extravascolare polmonare. In: Ecocardiografia per l’intensivista. Springer, Milano. https://doi.org/10.1007/978-88-470-1384-1_28
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DOI: https://doi.org/10.1007/978-88-470-1384-1_28
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