There is roughening and thickening of the pleural lining (should be smooth, thin and white) (red arrow) and hyperechoic B-lines, which are resonance or ring-down artifacts. The latter can be normal in low numbers (<3 per field) and when they are narrow. Increased numbers of B-lines (three in this field) that were thicker than normal indicated pulmonary pathology such as edema and infiltrates in the interstitium.
