Clinical application of transthoracic ultrasonography in inpatients with pneumonia

Sperandeo, Marco; Carnevale, Vincenzo; Muscarella, Silvana; Scionti, Giuseppe; Varriale, Antonio; Filabozzi, Paola; Piattelli, M.L.; D’Alessandro, Vito; Copetti, Massimiliano; Pellegrini, Fabio; Dimitri, L.; Vendemiale, Gianluigi

doi:10.1111/j.1365-2362.2010.02367.x

Cited by 80 publications

(77 citation statements)

References 25 publications

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“…However, the validity of these automated programs on the optimization of lung imaging, should be further investigated and discussed. variability and between subject variability (inter-reader agreement) did not show any difference between readers and estimated within-subject variability (intra-reader agreement) suggested a high repeatability of the method [41]. Gullett et al concluded that interobserver agreement was best in the anterior/superior thoracic zones followed by the lateral/superior zones for both expert/expert and expert/novice pairs.…”

Section: Focusmentioning

confidence: 99%

Lung artefacts and their use

Dietrich

Mathis²,

Blaivas

et al. 2016

Med Ultrason

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IntroductionIn years gone by examination of patients with pulmonary disorders rested essentially on a clinician's bedside physical examination, of auscultation and percussion, complimented with blood gas analysis and X-ray imaging. Lung ultrasound has emerged into this context as a real-time bedside procedure, delivering information relevant to the clinician's differential diagnosis. A large part of sonographic lung examination involves the interpretation of artefacts, thus knowledge of the origin of typical artefacts is important. Although indirect sonographic signs, nonetheless reliable conclusions on the condition of the lung can be inferred. Particularly the of quantity and distribution of B-lines can establish important assessment of the cause and degree of fluid load within the interstitium.All focused ultrasound investigations, including bedside lung ultrasound, allow symptom evaluation considering multiple organ-systems yet with minimal time delay. Such integration of imaging with clinical assessment and treatment is called Point-of-Care Ultrasound (POCUS) and should be understood as an extension of the physical examination. POCUS offers a unique but crucial role, integrating clinical and other imaging findings, including cardiac ultrasound (echocardiography), chest radiography, and computed tomography (CT) scans is crucial, which alone may lack the required accuracy.The emergence of differences in approach to lung sonography, technique and nomenclature, provided the AbstractThe science of lung ultrasound has grown tremendously over the last two decades and lung ultrasound has not only entered the mainstream of point of care ultrasound but has become a dominant topic. Understanding lung ultrasound signs and artifacts is critical to being able to correlate findings with actual pathology and normal anatomy and physiology. Investigators have described multiple lung ultrasound artifacts and findings and it is important to understand both the physics and anatomic basis behind them. Additionally, ultrasound machine use and transducer selection can significantly affect results obtained on patient during an examination and the provider must carefully choose the correct settings. This manuscript describes the state of the art in ultrasound artifact recognition and correlation as well as management of ultrasound technology to optimize diagnostic success.Keywords: ultrasound, lung, artifacts, pathology, guidelines [2,[11][12][13][14][15] we discuss the prominent role of the particular artefacts of lung sonography answering differential-diagnostic questions in patients with cardio-pulmonary diseases. Lung artefacts

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Section: Focusmentioning

confidence: 99%

Lung artefacts and their use

Dietrich

Mathis²,

Blaivas

et al. 2016

Med Ultrason

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“…By observing shape and echo-genic characteristics, it is possible to differentiate benign from malignant lesions. A cuneal shape or air bronchogram (Reissig and Kroegel, 2007;Sperandeo et al, 2011;Reissig et al, 2012) within a hypoechoic mass is highly suggestive of chronic inflammation (Figures 1, 2 and Table 3). Anatomically, pulmonary inflammation usually affects a segment or part of a segment of lung tissue, which leads to a cuneiform shape because of the bronchial construction.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of ultrasound-guided percutaneous biopsy of pulmonary lesions

Yang

Ruan

et al. 2015

Genet. Mol. Res.

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ABSTRACT. The purpose of this study was to evaluate the applicability of ultrasound-guided percutaneous biopsy for the diagnosis and differentiation of various pulmonary lesions in a Chinese population. A total of 338 pulmonary lesions were biopsied with 18-gauge cutting needles, guided by ultrasound, and sent for histopathological analysis. The ultrasonographic characteristics of these lesions, procedure complications, and histopathological diagnoses were analyzed. Sufficient specimen for histopathologic analysis was obtained in 95.64% (351/367), and mild complications occurred in 2.72% (10/367) of the patients. Accurate diagnosis was obtained in 94.03% (315/335) of the patients; 16 were lost to follow-up. Using the combination of shape and echogenicity to distinguish benign vs malignant lesions, diagnostic sensitivity and specificity were 57.39 and 95.65%, respectively. No significant difference was found between malignant and benign lesions in blood flow signals. Ultrasound-guided core biopsy is valuable for the diagnosis, management, and prognosis of unknown pulmonary lesions. Shape and echogenicity on ultrasonography correlate well with histopathology and provide useful information for distinguishing between Ultrasound-guided percutaneous biopsy benign and malignant lesions. On the contrary, color Doppler is of little value for this purpose.

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“…Pneumonic consolidation has more rapid and marked enhancement with sonographic contrast [54]. Consolidation may be difficult to detect when it is hidden behind bony structures [55] or does not extend to the pleura [56]. However, the latter is reportedly rare [51].…”

Section: Lung Consolidationmentioning

confidence: 99%

The efficacy of bedside chest ultrasound: from accuracy to outcomes

Hew

Tay

2016

Eur Respir Rev

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For many respiratory physicians, point-of-care chest ultrasound is now an integral part of clinical practice. The diagnostic accuracy of ultrasound to detect abnormalities of the pleura, the lung parenchyma and the thoracic musculoskeletal system is well described. However, the efficacy of a test extends beyond just diagnostic accuracy. The true value of a test depends on the degree to which diagnostic accuracy efficacy influences decision-making efficacy, and the subsequent extent to which this impacts health outcome efficacy. We therefore reviewed the demonstrable levels of test efficacy for bedside ultrasound of the pleura, lung parenchyma and thoracic musculoskeletal system.For bedside ultrasound of the pleura, there is evidence supporting diagnostic accuracy efficacy, decisionmaking efficacy and health outcome efficacy, predominantly in guiding pleural interventions. For the lung parenchyma, chest ultrasound has an impact on diagnostic accuracy and decision-making for patients presenting with acute respiratory failure or breathlessness, but there are no data as yet on actual health outcomes. For ultrasound of the thoracic musculoskeletal system, there is robust evidence only for diagnostic accuracy efficacy.We therefore outline avenues to further validate bedside chest ultrasound beyond diagnostic accuracy, with an emphasis on confirming enhanced health outcomes. @ERSpublicationsThe next challenge in bedside chest ultrasound is to refocus from diagnostic accuracy toward patient outcomes http://ow.ly/NyNR3027WLU

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Clinical application of transthoracic ultrasonography in inpatients with pneumonia

Abstract: TUS is easily reproducible and we proved it to be a useful complementary diagnostic tool for the diagnosis and the follow-up of CAP.

Cited by 80 publications

References 25 publications

Lung artefacts and their use

Lung artefacts and their use

Clinical value of ultrasound-guided percutaneous biopsy of pulmonary lesions

The efficacy of bedside chest ultrasound: from accuracy to outcomes

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