Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases (original) (raw)
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Emerging roles for transthoracic ultrasonography in pleuropulmonary pathology
World Journal of Radiology, 2010
As a result of many advantages such as the absence of radiation exposure, non-invasiveness, low cost, safety, and ready availability, transthoracic ultrasonography (TUS) represents an emerging and useful technique in the management of pleural and pulmonary diseases. In this second part of a comprehensive review that deals with the role of TUS in pleuropulmonary pathology, the normal findings, sonographic artifacts and morphology of the most important and frequent pulmonary diseases are described. In particular, the usefulness of TUS in diagnosing or raising suspicion of pneumonia, pulmonary embolism, atelectasis, diffuse parenchymal diseases, adult and newborn respiratory distress syndrome, lung cancer and lung metastases are discussed, as well as its role in guidance for diagnostic and therapeutic interventional procedures. Moreover, the preliminary data about the role of contrast enhanced ultrasonography in the study of pulmonary pleural-based lesions are also reported. Finally, the limits of TUS when compared with chest computed tomography are described, highlighting the inability of TUS to depict lesions that are not in contact with the pleura or are located under bony structures, poor visualization of the mediastinum, and the need for very experienced examiners to obtain reliable results.
Role of ultrasound in the management of pleural diseases in respiratory intensive care patients
Egyptian Journal of Bronchology, 2015
Introduction Ultrasonography (US) has become an invaluable tool in the management of critically ill patients. Objectives This study aimed to evaluate the role of US in the diagnosis and treatment of pleural diseases in patients in the respiratory intensive care unit. Patients and methods This study recruited 55 patients who presented with suspected clinical and/or radiological evidence of pleural disease in whom US and chest radiography were performed. In addition, US-guided interventions were carried out whenever needed and computed tomography scans of the chest where obtained whenever possible. Results Pleural effusion was the most common pleural disease encountered (54.5%). US correctly predicted the nature of most pleural effusions, whether transudative or exudative (84%). US was significantly more sensitive than chest radiography in the diagnosis of pleural effusion and pleural thickening (P = 0.00 and 0.004, respectively) and had significantly better sensitivity for unilateral...
Journal of Fatima Jinnah Medical University, 2020
Background: Conventionally Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography. Trans-thoracic pleural aspiration is done and aspirated pleural fluid is considered the gold-standard for pleural effusion. Chest sonography has the advantage of having high diagnostic efficacy over radiography for the detection of pleural effusion. Furthermore, ultrasonography is free from radiation hazards, inexpensive, readily available and feasible for use in ICU, pregnant and pediatric patients. This study aims to explore the diagnostic accuracy of trans-thoracic ultrasonography for pleural fluid detection, which is free of such disadvantages. The objective is to determine the diagnostic efficacy of trans-thoracic ultrasound for detecting pleural effusion and also to assess its suitability for being a non-invasive gold-standard. Subject and Methods: This retrospective study of 4597 cases was conducted at pulmonology OPD-Gulab Devi Te...
Egyptian Journal of Chest Diseases and Tuberculosis, 2016
Background: Medical thoracoscopy increases the diagnostic yield in patients with undiagnosed pleural effusion. Ultrasound guided pleural biopsies are safe procedures with high diagnostic yields. Objective: To compare safety and efficacy of medical thoracoscopic versus ultrasound guided transthoracic needle biopsy in the diagnosis of pleural lesions. Patients and methods: 40 patients with undiagnosed pleural lesions were divided into 2 groups. After clinical, radiological examination and laboratory investigations; pleural biopsies were taken by ultrasound guided needle biopsy and medical thoracoscopy in group I and II respectively. Results: Complications in group I were in the form of pain in 2 patients (10%), hemoptysis in 1 (5%), while complications in group II were pain in 4 (20%), failure of the lung to expand in 5 (25%), pneumothorax in 5 (25%) and wound infection in 3 patients (15%). Final histopathological diagnosis in group I was parapneumonic effusion in 3 patients (15%), inflammatory lung lesion in 1 (5%), pleural fibroma in 2 (10%), malignant mesothelioma in 4 (20%), sarcoma in 1 (5%), adenocarcinoma in 1 (5%), squamous cell carcinoma in 4 (20%), and metastatic adenocarcinoma in 1 (5%). Final histopathological diagnosis in group II was pleural TB in 4 patients (20%), inflammatory lung lesions in 2 (10%), malignant mesothelioma in 6 (30%), adenocarcinoma in 5 (25%), and metastatic adenocarcinoma in 2 (10%). The diagnosed cases were 17 (85%) and 19 (95%) in groups I and II respectively. Conclusions: Medical thoracoscopy is an important diagnostic method for the diagnosis of undiagnosed pleural effusion while it is concluded that US guided pleural biopsy is more useful in cases of pleural lesions without effusion.
Role of ultrasonography in the diagnosis of pleural effusion
Egyptian Journal of Bronchology
Background Transthoracic ultrasonography (TUS) represents a useful diagnostic tool in the management of pleural diseases. It is the best method for guiding interventional procedures in the pleural space. Objectives The aim of this study was to detect the role of ultrasonography (US) in the diagnosis and management of pleural effusion in comparison with computed tomography (CT). Patients and methods Patients with suspected clinical and radiological evidence of pleural effusion were included. Routine laboratory investigations, chest radiography, CT of the chest, TUS, and thoracentesis with biochemical, bacteriological, and cytological examination of pleural fluid were carried out for all patients, and medical thoracoscopy and US-assisted interventions were carried out whenever needed. Results Eighty-four patients were included in the study. Male patients represented 56% (47 cases), whereas female patients constituted 44% (37 cases); their mean age was 51.21±14.1 years (range: 14-80 years). Seventy-three (86.9%) cases had exudative effusions; inflammatory causes (n=33) and malignancy (n=31) were the most common. TUS was equal to CT in the detection of pleural effusion, pleural thickening, hydropneumothorax, pleural nodule, and consolidation. Moreover, US was better than chest radiography in the detection of pleural thickening, encysted pleural effusion, pleural mass, and consolidation. US was better than CT in the detection of septations (n=30 vs. 5). However, CT was better than US in the detection of loculation (n=28 vs. 17) and pulmonary mass (n=8 vs. 4). Thorcoscopy was performed for nine patients, and was better than US and CT in the detection of pleural nodules. Conclusion TUS is an efficient, quick, inexpensive, radiationfree method for the evaluation of pleural diseases.
Journal of Hunan University Natural Sciences, 2022
Recently, there is an increase application of chest ultrasound to evaluate and monitor pleuropulmonary diseases. Computed tomography (CT) is the gold standard for most different lung pathologies with limitations. This study aims to assess the effectiveness of Chest Ultrasound compared to Computed Tomography in diagnosis of different pleuropulmonary disorders and to define the rules of chest ultrasound in pulmonary medicine. This study was conducted upon randomly selected 110 patients with different pleuropulmonary disorders who were admitted to the respiratory ward and ICU, Zagazig University Hospitals, from April 2018 to April 2020. All patients with abnormal chest X. ray opacities were evaluated for complete history taking, full clinical examination, laboratory investigations, then Chest US was performed on the first day of admission then CT was done as a gold standard for the final diagnosis then results of both Chest US and CT were compared. Compared to CT, Chest US had sensitivity (95.8%) for free pleural effusion diagnosis, specificity (90.3%), and (92.7%) accuracy; for pneumonia, (90.9%), (96.1%), and (94.5%) respectively, while pneumothorax had (81.8%), (98%), and (96.3%) accuracy, respectively; for pulmonary edema, (89.5%), (97.8%), and (96.4%) accuracy, respectively. The US plays a valuable role in the diagnosis of different pleuropulmonary diseases and can be used as the first routine radiological modality in both ward & ICU.
Role of Chest Ultrasound in Assessment of Different Pleural Lesions
IOSR Journals , 2019
Background: Ultrasound is useful in lung and pleural evaluation due to its real-time response characteristics. Add to that, its portability, bedside availability and absence of ionizing radiation; therefore, it is a safe technique for all patients. It can evaluate abnormalities in the peripheral lung parenchyma, pleura and chest wall. It may also be used to guide invasive procedures, such as pleural puncture, biopsy and chest tube insertion.Aim of the Work: to evaluate the role of ultrasound for diagnosis and assessment of different pleural lesions and the possibility to differentiate between benign and malignant pleural diseases. Patients and methods: This study was conducted on 30 patients. They were referred to radiology department at National cancer institute and Ain Shams University hospitals with different pleural lesionsbetween May and December of 2018. Results:Compared to CT scans, US is easier to perform and may better differentiate between pleural thickening and pleural effusion. Besides, it could detect very low amounts of effusion, as low as 3-5 ml of fluid. Chest ultrasound also served a role in tissue characterization through identifying morphology of growth in forms of non-uniformity of the pleura and heterogeneity of different tissues. Conclusion: Pleural ultrasound was a reliable tool in evaluation of different aspects of pleural growth and neoplasia, detection of the extent of spread to the chest wall and diaphragm in neoplastic lesions and predicting the nature of the pleural effusion through detecting internal echoes and septations.
Role of ultrasound in diagnosis of pleural and parenchymal lung diseases in OPD patients
2020
Background & Objective: Thoracic CT is the most common imaging modality used after screening with chest x-ray in treatment of lung pathologies. But high cost, radiation, immobility & availability restrict its widespread use. For many years transthoracic ultrasound is being used in examination of pleural effusions in ICU patients. To study the role of chest ultrasonography in diagnosing pleural & parenchymal pathologies in OPD patients this study was carried out. Materials and Methods: 32 adult patientswithdyspnoea, cough & other chest symptoms coming to OPD of pulmonary department of Santosh hospitals from January 2017 to July 2018 were enrolled in the study. Results: In diagnosing pleural lung diseasespleural effusion, pneumothorax, hydropneumothorax and pleural thickening, US showed a sensitivity, specificity, PPV & NPV all of 100% and accuracy of 1.00. But for parenchymal lesions taken all together (Consolidation, collapse, atelectasis, lung abscess, fibrocavitary lesion with nec...
Ultrasound of the Pleurae and Lungs
Ultrasound in Medicine & Biology, 2015
The value of ultrasound techniques in examination of the pleurae and lungs has been underestimated over recent decades. One explanation for this is the assumption that the ventilated lungs and the bones of the rib cage constitute impermeable obstacles to ultrasound. However, a variety of pathologies of the chest wall, pleurae and lungs result in altered tissue composition, providing substantially increased access and visibility for ultrasound examination. It is a great benefit that the pleurae and lungs can be non-invasively imaged repeatedly without discomfort or radiation exposure for the patient. Ultrasound is thus particularly valuable in follow-up of disease, differential diagnosis and detection of complications. Diagnostic and therapeutic interventions in patients with pathologic pleural and pulmonary findings can tolerably be performed under real-time ultrasound guidance. In this article, an updated overview is given presenting not only the benefits and indications, but also the limitations of pleural and pulmonary ultrasound.