Chest Ultrasound- Update 2018

Abstract

The scope of applications of chest ultrasound has been significantly widened in the last few years. Effusions as little as 5 ml can be identified without problems in a standing or sitting position laterodorsal in the angle between the chest wall and the diaphragm.Portable ultrasound systems are being used to an increasing extent in preclinical sonography, at the site of trauma, in the ambulance of the emergency physician or in helicopters. In the emergency room, at the intensive care unit and in clinical routine, chest ultrasound has proved its worth as a strategic instrument to be used directly after the clinical investigation. Several diagnoses such as pneumothorax, (no sliding sign, no B-lines, no lung pulse, lung point) pneumonia (liver like consolidation with bronchoaerogram) rib fractures (step in cortical bone and hematoma) pulmonary embolism (typical subpleural lesions) can be established immediately. In combination with echocardiography and leg vein compression ultrasound (triple organ ultrasound), the accuracy is more than 90%. The evidence of interstitial syndrome has shown a significant correlation with extravascular lung water in cases of pulmonary edema and noncardiogenic pulmonary edema.Chest ultrasound helps in the diagnosis and staging of lung cancer. Contrast ultrasound (CEUS) is a new tool for the differentiation of sub pleural lung lesions. Ultrasound guided interventions (biopsy, drainage) are very successful. The rate of complications is low when the procedure is performed by trained therapists.Ultrasound is a fixed element of several international guidelines.

Spectrum of Chest Imaging Data in Children With Inflammatory Lung Diseases

“…B-lines, or "comet tail" artifacts, the number of which increases in pulmonary pathology (the more severe the course of the pathological process and the more pronounced changes in lung tissues, the more such artifacts) are easily detectable hyperechoic linear formations extending from pleura, against the background of preservation of echogenicity, and are indicated as one of the main signs of interstitial changes in the lungs, characterized by the presence of appropriate interstitial infiltration. According to the data we obtained in the article, which are consistent with the opinion of foreign authors, the visualization of multiple B-lines in certain scanning areas, which is due to the accumulation of extravascular fluid in the interlobular septa and their subsequent thickening, indicates the presence of interstitial disorders [10,11,12]. So, for example, with pulmonary edema, a uniform, often symmetrical on both sides, arrangement of multiple B-lines over the entire surface of the lung fields is observed.…”

The Role of Chest Ultrasound Combined with Plasma Brain Natriuretic Peptide in The Differentiation between Cardiogenic and Noncardiogenic Pulmonary Edema

“…Transthoracic ultrasound is an easy, bedside, lowcost, and lacks radiation tool that has proved its worth as a strategic instrument to be used directly after the clinical investigation in the emergency room, intensive care unit, operating room, and clinical routine (6) . It has developed into an important point-of-care (POC) tool for the evaluation of a range of pulmonary and pleural disease states, including pleural effusion, empyema, pneumonia, pneumothorax, lung cancer, and pulmonary embolism (7) .…”