Ultrasonography of neonatal lung disease

Respiratory disorders represent one of the most common causes of morbidity and admission to neonatal intensive care units (NICUs). Traditionally, chest radiography has been the primary imaging modality for evaluating neonatal lung disease; however, it exposes patients to radiation and may lack sensitivity for early or subtle abnormalities. In the past twenty years lung ultrasound (LUS) has emerged as a valuable bedside imaging tool in neonatology due to its safety, repeatability, low cost and high diagnostic accuracy. Not only LUS can describe common neonatal respiratory disorders (respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, pneumothorax, and meconium aspiration syndrome), it has functional applications to help clinical decisions (such as surfactant administration, chest drainage etc). This review summarizes the basic principles of neonatal lung ultrasound, describes normal and pathological sonographic findings, and discusses the characteristic ultrasound patterns of the most common neonatal lung diseases.