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Ultrasound lung rockets (ULRs), more recently termed B‐lines (Volpicelli et al. 2012), are vertical, narrow‐based lines arising from the near‐field's pulmonary–pleural line, extending to the far edge of the ultrasound screen, always obliterating A‐lines, and moving “to and fro” in concert with inspiration and expiration. Although B‐lines are similar to comet‐tail artifacts, they are specifically created by the strong difference in impedance of air adjacent to a small amount of water and are the ultrasound near‐equivalent of radiographic Kerley B lines (representing interlobar edema). Their clinical relevance is very important and explained later (see Chapters 22 and 23) (Lichtenstein and Meziere 2008; Lichtenstein et al. 2009; Lisciandro 2011; Volpicelli et al. 2012) (Figure 3.6).

Figure 3.6. Pseudo B‐lines. The B‐line artifact begins at the lung's pleural surface and continues without loss of intensity through the far‐field of the image as a hyperechoic (bright white) streak that obliterates A‐lines. In real time, B‐lines must oscillate with the to‐and‐fro motion of inspiration and expiration. Examples and descriptions are found in Chapters 22 and 23. Here, however, are pseudo B‐lines. In (A), what appears to be a single B‐line is in fact tightly stacked A‐lines off the far side of a very small lung nodule. In (B) are multiple pseudo B‐lines off the gastric wall. In (C) the nodule is indicated with a solid black circle overlay, and the arrows are over the pseudo B‐line. In (D), the pseudo B‐lines are indicated by the arrows (←).

Source: Courtesy of Dr Gregory Lisciandro, Hill Country Veterinary Specialists and FASTVet.com, Spicewood, TX.