{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:04:03Z","timestamp":1793059443038,"version":"4.5.0"},"reference-count":57,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The diagnosis of pulmonary embolism (PE) relies essentially on a probabilistic approach that requires careful clinical assessments, targeted laboratory tests, and the use of appropriate imaging tools. Nowadays, the diagnostic gold standard is computed tomographic pulmonary angiography. Lung ultrasound (LUS) can play a role in the diagnosis of PE mainly by allowing the visualization of peripheral lung infarctions. Hypoechoic, pleural-based parenchymal consolidation is the most typical and common finding of pulmonary infarction. More than 85% of infarct lesions are wedge-shaped, extending to the pleural surface and are localized to where the patient complains of pleuritic chest pain. Contrast-enhanced ultrasound can be performed in addition to basic ultrasound examination to ascertain nonvascularization of the consolidation, thus confirming that the lesion is an infarct. The aim of this narrative review is to summarize the latest evidence on the application of LUS to the diagnosis of PE, focusing purely on thoracic\/lung signs.<\/jats:p>","DOI":"10.1055\/s-0043-1776006","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T19:03:01Z","timestamp":1697223781000},"page":"842-850","source":"Crossref","is-referenced-by-count":19,"title":["The Diagnostic Role of Lung Ultrasound and Contrast-Enhanced Ultrasound in Pulmonary Embolism"],"prefix":"10.1055","volume":"50","author":[{"given":"Andrea","family":"Boccatonda","sequence":"additional","affiliation":[{"name":"Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Andreetto","sequence":"additional","affiliation":[{"name":"Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Vicari","sequence":"additional","affiliation":[{"name":"Internal Medicine, Bentivoglio Hospital, AUSL Bologna, Bentivoglio (BO), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Campello","sequence":"additional","affiliation":[{"name":"General Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, University Hospital of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[{"name":"General Medicine and Thrombotic and Hemorrhagic Diseases Unit, Department of Medicine, University Hospital of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Ageno","sequence":"additional","affiliation":[{"name":"Research Center on Thromboembolic Diseases and Antithrombotic Therapies, Department of Medicine and Surgery, University of Insubria, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"issue":"02","key":"ref1","first-page":"129","article-title":"Pulmonary embolism, Part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and nonthrombotic pulmonary embolism","volume":"18","author":"J B\u0115lohl\u00e1vek","year":"2013","journal-title":"Exp Clin Cardiol"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1038\/nrcardio.2010.106","article-title":"Acute pulmonary embolism. Part 1: epidemiology and diagnosis","volume":"7","author":"R A Douma","year":"2010","journal-title":"Nat Rev Cardiol"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1055\/s-2008-1027856","article-title":"Transthoracic sonography for the detection of pulmonary embolism\u2013a meta-analysis","volume":"30","author":"T Niemann","year":"2009","journal-title":"Ultraschall Med"},{"issue":"16","key":"ref4","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1161\/CIR.0b013e318214914f","article-title":"Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association","volume":"123","author":"M R Jaff","year":"2011","journal-title":"Circulation"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1159\/000074195","article-title":"Transthoracic ultrasound of lung and pleura in the diagnosis of pulmonary embolism: a novel non-invasive bedside approach","volume":"70","author":"A Reissig","year":"2003","journal-title":"Respiration"},{"issue":"01","key":"ref6","doi-asserted-by":"crossref","first-page":"31","DOI":"10.2214\/ajr.184.1.01840031","article-title":"Universal use of nonionic iodinated contrast medium for CT: evaluation of safety in a large urban teaching hospital","volume":"184","author":"K J Mortel\u00e9","year":"2005","journal-title":"AJR Am J Roentgenol"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"2546","DOI":"10.1016\/j.ultrasmedbio.2020.04.036","article-title":"The \u201csurvived lung:\u201d an ultrasound sign of \u201cbubbly consolidation\u201d pulmonary infarction","volume":"46","author":"R Copetti","year":"2020","journal-title":"Ultrasound Med Biol"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.thromres.2021.03.022","article-title":"Pulmonary infarction in acute pulmonary embolism","volume":"202","author":"F HJ Kaptein","year":"2021","journal-title":"Thromb Res"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1007\/s00134-012-2513-4","article-title":"International evidence-based recommendations for point-of-care lung ultrasound","volume":"38","author":"G Volpicelli","year":"2012","journal-title":"Intensive Care Med"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.3390\/jcm11082067","article-title":"Role of lung ultrasound in the management of patients with suspected SARS-CoV-2 infection in the Emergency Department","volume":"11","author":"A Boccatonda","year":"2022","journal-title":"J Clin Med"},{"issue":"01","key":"ref11","first-page":"255","article-title":"All B-lines are equal, but some B-lines are more equal than others","volume":"26","author":"A Boccatonda","year":"2023","journal-title":"J Ultrasound"},{"key":"ref12","first-page":"jead169","article-title":"Lung ultrasound in acute and chronic heart failure. 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Stein","year":"1981","journal-title":"Am J Cardiol"},{"issue":"04","key":"ref22","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/0002-9343(82)90458-2","article-title":"Pathogenesis of pulmonary infarction","volume":"72","author":"M S Tsao","year":"1982","journal-title":"Am J Med"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1056\/NEJM196506172722406","article-title":"Frequency of pulmonary thromboembolism in man","volume":"272","author":"D G Freiman","year":"1965","journal-title":"N Engl J Med"},{"issue":"06","key":"ref24","first-page":"440","article-title":"Lung infarction following pulmonary embolism: a comparative study on clinical conditions and CT findings to identify predisposing factors","volume":"187","author":"J Kirchner","year":"2015","journal-title":"R\u00f6fo"},{"issue":"09","key":"ref25","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1111\/resp.13299","article-title":"Pulmonary infarction secondary to pulmonary 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registry","volume":"130","author":"J L Lobo","year":"2006","journal-title":"Chest"},{"issue":"25","key":"ref29","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1056\/NEJM197706232962503","article-title":"Pulmonary embolism, pulmonary hemorrhage and pulmonary infarction","volume":"296","author":"J E Dalen","year":"1977","journal-title":"N Engl J Med"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/ajcp\/84.1.15","article-title":"Factors associated with pulmonary infarction. A discriminant analysis study","volume":"84","author":"D E Schraufnagel","year":"1985","journal-title":"Am J Clin Pathol"},{"issue":"04","key":"ref31","first-page":"1178","article-title":"Causes and presenting features of pulmonary infarctions in 43 cases identified by surgical lung biopsy","volume":"127","author":"J G Parambil","year":"2005","journal-title":"Chest"},{"issue":"12","key":"ref32","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1016\/j.ejrad.2014.07.016","article-title":"Multimodality imaging of pulmonary infarction","volume":"83","author":"T JP Bray","year":"2014","journal-title":"Eur J Radiol"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.thromres.2023.04.005","article-title":"Impact of pulmonary infarction in pulmonary embolism on presentation and outcomes","volume":"226","author":"F HJ Kaptein","year":"2023","journal-title":"Thromb Res"},{"issue":"03","key":"ref34","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/0720-048X(93)90098-8","article-title":"Pulmonary infarction: sonographic appearance with pathologic correlation","volume":"17","author":"G Mathis","year":"1993","journal-title":"Eur J Radiol"},{"key":"ref35","first-page":"262","article-title":"Reflected ultrasound in the detection of pulmonary embolism","volume":"79","author":"C R Joyner Jr","year":"1966","journal-title":"Trans Assoc Am Physicians"},{"issue":"02","key":"ref36","doi-asserted-by":"crossref","first-page":"226","DOI":"10.11152\/mu-3049","article-title":"Clinical value of thoracic ultrasonography in the diagnosis of pulmonary embolism: a systematic review and meta-analysis","volume":"24","author":"W Chen","year":"2022","journal-title":"Med Ultrason"},{"issue":"06","key":"ref37","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1378\/chest.120.6.1977","article-title":"Sonography of lung and pleura in pulmonary embolism: sonomorphologic characterization and comparison with spiral CT scanning","volume":"120","author":"A Reissig","year":"2001","journal-title":"Chest"},{"issue":"03","key":"ref38","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0720-048X(03)00141-4","article-title":"Ancillary lung parenchymal findings at spiral CT scanning in pulmonary embolism. Relationship to chest sonography","volume":"49","author":"A Reissig","year":"2004","journal-title":"Eur J Radiol"},{"issue":"06","key":"ref39","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1093\/eurheartj\/14.6.804","article-title":"Sonographic observation of pulmonary infarction and early infarctions by pulmonary embolism","volume":"14","author":"G Mathis","year":"1993","journal-title":"Eur Heart J"},{"issue":"01","key":"ref40","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1097\/00004728-199001000-00013","article-title":"CT of inflation-fixed lungs: wedge-shaped density and vascular sign in the diagnosis of infarction","volume":"14","author":"H Ren","year":"1990","journal-title":"J Comput Assist Tomogr"},{"issue":"04","key":"ref41","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/MCP.0b013e32835395d5","article-title":"Pleural effusion in pulmonary embolism","volume":"18","author":"S Findik","year":"2012","journal-title":"Curr Opin Pulm Med"},{"issue":"04","key":"ref42","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.3390\/jcm12041402","article-title":"Infectious pneumonia and lung ultrasound: a review","volume":"12","author":"A Boccatonda","year":"2023","journal-title":"J Clin Med"},{"issue":"01","key":"ref43","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1148\/radiology.211.1.r99ap03147","article-title":"Parenchymal and pleural findings in patients with and patients without acute pulmonary embolism detected at spiral CT","volume":"211","author":"A A Shah","year":"1999","journal-title":"Radiology"},{"issue":"03","key":"ref44","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1378\/chest.128.3.1531","article-title":"Thoracic ultrasound for diagnosing pulmonary embolism: a prospective multicenter study of 352 patients","volume":"128","author":"G Mathis","year":"2005","journal-title":"Chest"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"4","DOI":"10.4103\/2277-9175.174975","article-title":"Diagnostic validity of ultrasonography in evaluation of pulmonary thromboembolism","volume":"5","author":"A Abootalebi","year":"2016","journal-title":"Adv Biomed Res"},{"issue":"07","key":"ref46","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/jth.12232","article-title":"Diagnostic accuracy of lung ultrasound for pulmonary embolism: a systematic review and meta-analysis","volume":"11","author":"A Squizzato","year":"2013","journal-title":"J Thromb Haemost"},{"issue":"06","key":"ref47","doi-asserted-by":"crossref","first-page":"e0129909","DOI":"10.1371\/journal.pone.0129909","article-title":"Role of transthoracic lung ultrasonography in the diagnosis of pulmonary embolism: a systematic review and meta-analysis","volume":"10","author":"L Jiang","year":"2015","journal-title":"PLoS ONE"},{"issue":"02","key":"ref48","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1055\/a-0586-1107","article-title":"The EFSUMB Guidelines and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound (CEUS) in Non-Hepatic Applications: Update 2017 (Long Version)","volume":"39","author":"P S Sidhu","year":"2018","journal-title":"Ultraschall Med"},{"key":"ref49","doi-asserted-by":"crossref","first-page":"1086251","DOI":"10.3389\/fonc.2023.1086251","article-title":"Correlations between contrast-enhanced ultrasound and microvessel density in non-small cell lung cancer: a prospective study","volume":"13","author":"W Chen","year":"2023","journal-title":"Front Oncol"},{"issue":"07","key":"ref50","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1002\/jum.15852","article-title":"Peripheral pulmonary lesions in confirmed pulmonary arterial embolism: follow-up study of B-mode ultrasound and of perfusion patterns using contrast-enhanced ultrasound (CEUS)","volume":"41","author":"E Safai Zadeh","year":"2022","journal-title":"J Ultrasound Med"},{"issue":"03","key":"ref51","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/jcu.22313","article-title":"Contrast-enhanced ultrasound of embolic consolidations in patients with pulmonary embolism: a pilot study","volume":"44","author":"S Bartelt","year":"2016","journal-title":"J Clin Ultrasound"},{"issue":"02","key":"ref52","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s40477-020-00517-z","article-title":"The use of contrast-enhanced ultrasound in COVID-19 lung imaging","volume":"25","author":"G T Yusuf","year":"2022","journal-title":"J Ultrasound"},{"issue":"03","key":"ref53","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/1742271X211047945","article-title":"Point-of-care contrast enhanced lung ultrasound and COVID-19","volume":"30","author":"A Tee","year":"2022","journal-title":"Ultrasound"},{"issue":"04","key":"ref54","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS)","volume":"41","author":"S V Konstantinides","year":"2020","journal-title":"Eur Heart J"},{"issue":"02","key":"ref55","doi-asserted-by":"crossref","first-page":"99","DOI":"10.4103\/1817-1737.109822","article-title":"The role of thoracic ultrasonography in the diagnosis of pulmonary embolism","volume":"8","author":"S S Comert","year":"2013","journal-title":"Ann Thorac Med"},{"issue":"01","key":"ref56","doi-asserted-by":"crossref","first-page":"20240","DOI":"10.3402\/jchimp.v3i1.20240","article-title":"CT pulmonary angiography: an over-utilized imaging modality in hospitalized patients with suspected pulmonary embolism","volume":"3","author":"P S 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