{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:30:18Z","timestamp":1779330618319,"version":"3.51.4"},"reference-count":44,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,9]],"date-time":"2025-03-09T00:00:00Z","timestamp":1741478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Lung ultrasound holds high diagnostic performance for pleural diseases, notably pneumothorax. Bullous emphysema is a potential differential diagnosis of pneumothorax on ultrasound, but its precise semiology is poorly known. This study aimed to delineate the sonographic presentation of bullous emphysema and assess the diagnostic performance of common ultrasound features in identifying bullae.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From June 2019 to June 2021, patients with CT scanner\u2010confirmed bullous emphysema were prospectively included. Investigators performed a standardised 14\u2010region lung ultrasound. Sonographic features of bullous and non\u2010bullous regions were compared. Diagnostic performances for bullae were calculated for each sign, and an additive score was constructed using signs with specificity &gt;\u200985%. Pearson's correlation was used to examine the relationship between this score, bulla size, and respiratory functional parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010six patients were included, mostly male (<jats:italic>n<\/jats:italic>\u2009=\u200933 patients, 91.7%), with an average age of 62\u2009\u00b1\u200911\u2009years. Bullae mostly affected apical regions (<jats:italic>n<\/jats:italic>\u2009=\u200924 patients, 67%). Bullous regions displayed a more frequent absence of lung sliding (34% vs. 11% in non\u2010bullous regions, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), barcode sign (15% vs. 3%, p\u2009&lt;\u20090.01), increased A\u2010line visibility (16% vs. 8%, <jats:italic>p<\/jats:italic>\u2009=\u20090.048), and absence of Z lines (62% vs. 44%, <jats:italic>p<\/jats:italic>\u2009=\u20090.018). A bulla\u2010point sign was visualised in 4% of bullous regions. Absent lung sliding was more frequent in patients with pulmonary distension and in apical regions. Patient bulla score (3 [2\u20136]) correlated with bulla size (<jats:italic>r<\/jats:italic>\u2009=\u20090.53 [0.25;0.73], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), FEV<jats:sub>1<\/jats:sub> (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.38 [\u22120.60;\u22120.03], <jats:italic>p<\/jats:italic>\u2009=\u20090.022), and forced vital capacity (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.38 [\u22120.64;\u22120.08], <jats:italic>p<\/jats:italic>\u2009=\u20090.021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings challenge previous data about the specificity of ultrasound signs of pneumothorax in patients with bullous emphysema, highlighting the need for cautious interpretation in clinical practice.<\/jats:p><jats:p>\n<jats:bold>Trial Registration:<\/jats:bold> NCT04012359<\/jats:p><jats:p>\n<jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/resp70021-gra-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.70021","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T11:46:31Z","timestamp":1741693591000},"page":"633-643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Mapping Bullous Emphysema With Lung Ultrasound: A Prospective Multicentre Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9188-833X","authenticated-orcid":false,"given":"Kinan","family":"El Husseini","sequence":"first","affiliation":[{"name":"Department of Pneumology Thoracic Oncology and Respiratory Intensive Care Unit  Rouen France"},{"name":"Department of Pneumology A CHU Bichat, APHP  Paris France"},{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Flament","sequence":"additional","affiliation":[{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"},{"name":"Department of Respiratory Medicine CHU Tours  Tours France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Laroumagne","sequence":"additional","affiliation":[{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"},{"name":"Department of Thoracic Oncology Pleural Diseases and Interventional Pulmonology, AP\u2010HM  Marseille France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damien","family":"Basille","sequence":"additional","affiliation":[{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"},{"name":"Department of Pneumology and Critical Care Unit CHU Amiens\u2010Picardie  Amiens France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilde","family":"Le Brun","sequence":"additional","affiliation":[{"name":"Department of Pneumology Thoracic Oncology and Respiratory Intensive Care Unit  Rouen France"},{"name":"Department of Pneumology A CHU Bichat, APHP  Paris France"},{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"No\u00ebl\u2010Savina","sequence":"additional","affiliation":[{"name":"G\u2010ECHO: Lung Ultrasound Working Group of the French Society of Respiratory Diseases (SPLF)  Paris France"},{"name":"Department of Pneumology Larrey Hospital, CHU Toulouse  Toulouse 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