Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo, Marco; Filabozzi, Paola; Varriale, Antonio; Carnevale, Vincenzo; Piattelli, M.L.; Scionti, Giuseppe; Brunetti, Enrico; Decuzzi, M.

doi:10.1016/j.jus.2008.02.001

Cited by 79 publications

(78 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For the time being, pleuropulmonary ultrasonography can be considered a complementary method for diagnosing several chest diseases; it is also an optimal guide during percutaneous procedures involving the aspiration of pleural effusions or the biopsy of peripheral pleural and lung consolidations [24,25]. The enthusiasm raised by the wellknown advantages of ultrasound -widespread availability, noninvasiveness, low costs have to be reconciled with the limitations of this imaging modality in the chest.…”

Section: Resultsmentioning

confidence: 99%

Characterization of the normal pulmonary surface and pneumonectomy space by reflected ultrasound

Sperandeo

Varriale

Scionti

et al. 2011

Journal of Ultrasound

Self Cite

View full text Add to dashboard Cite

KEYWORDSTransthoracic; Normal pleuropulmonary; Pneumonectomy space; Ultrasound artifacts.Abstract Interest has been increasing in the use of transthoracic ultrasound for the study of the pleuropulmonary disease. US imaging depends mainly on the physical interactions between ultrasound waves and the tissues being examined. In the thoracic region, the prescence of the chest wall and the air-containing pulmonary tissues cause various artifacts that strongly influence the resulting images. At the interface between tissues and air, the ultrasound beam is totally reflected and produces simple reverberation, comet-tail artifacts, and ring-down artifacts. We report the findings of transthoracic ultrasound in normal healthy subjects and in those who had undergone pneumonectomy.This experience shows that, in terms of the ultrasound artifacts mentioned above, the postpneumonectomy cavity is not significantly different from the healthy lung.Sommario SommarioL'interesse nell'utilità dell'ecografia del torace si è di recente accresciuto specialmente nello studio delle malattie pleuro-polmonari. L'immagine ecografica dipende prevalentemente dalle interazioni fisiche tra gli ultrasuoni e i tessuti esaminati; pertanto nello studio del torace la presenza della gabbia toracica e del tessuto polmonare contenente aria influenza fortemente le immagini generando molteplici artefatti. Il fascio ultrasonoro passando attraverso l'interfaccia tessuti/aria è quasi totalmente riflesso, producendo semplici riverberazioni (artefatti orizzontali), "comet-tail" e "ring-down" (artefatti verticali). Riportiamo gli effetti fisici implicati nella formazione di artefatti durante l'ecografia del torace in soggetti normali confrontati con lo spazio residuo post-pneumonectomia. In tutti i soggetti sani esaminati così come nella cavità residua dopo pneumonectomia abbiamo rilevato tutti gli artefatti descritti in accordo con i principi fisici degli ultrasuoni. ª

show abstract

Section: Resultsmentioning

confidence: 99%

Characterization of the normal pulmonary surface and pneumonectomy space by reflected ultrasound

Sperandeo

Varriale

Scionti

et al. 2011

Journal of Ultrasound

Self Cite

View full text Add to dashboard Cite

show abstract

“…Chest ultrasonography is the "gold standard" method for the study of pleural effusions (26). Ultrasound diagnosis of pleural effusion is simple and accurate.…”

Section: Diagnostic Ultrasound In Pleural Effusionsmentioning

confidence: 99%

Transthoracic ultrasound for pleural effusion: traps and tricks

Sperandeo¹

2014

sob

View full text Add to dashboard Cite

SummaryPleural effusion is excess fluid that accumulates between the two pleural layers. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during ventilation. Pleural effusion is still usually diagnosed on the basis of medical history and physical examination, and confirmed by chest x-ray. It is observed in many pulmonary and extra-pulmonary disease; its cause can be relatively benign or definitely malign (cancer), and may require drainage for treatment or for achieving a diagnosis which is available at the bedside by physical examination and Thoracic Ultrasound (TUS). Pleural effusion is detected by TUS even when its volume is very little: it is possible to perform and repeat at bedside, by sufficiently trained physicians. Diagnostic intervention procedures are safer if performed using US probes specifically designed for this use, i.e. with a central hole which allows the co-axial passage of the disposable tools for drainage or Fine Needle Aspiration Biopsy (FNAB). Over-trusting in US criteria not evidence-based and, more important, which are demonstrated to be unreliable when critically re-appraised must be discouraged; reversal of such scarcely validated but recommended practices, which could be harmful for patients, is actively in progress also in this field of medicine. No special trick is needed and no actual trap is present when the assessment of pleural effusion is performed by a sufficiently skilled MD and with a reliable and well set echo machine. Echo-assisted thoracentesis is an excellent procedure when appropriately performed in all its phases, which are: choice of the site of insertion, visualization in real-time during the drainage and serial control during lung re-expansion (so as to avoid pneumothorax). KEY WORDS: ultrasound, pleural effusion. Transthoracic ultrasound: overviewThe ultrasound examination in the study of pleuro-pulmonary disease, i.e. Thoracic Ultra-Sound (TUS), is limited by the presence of air in the lungs and by the rib cage (1). As a consequence TUS is not an all purpose tool, drawbacks and appropriate indications must be the cynosure of the pneumologist which relies on TUS for diagnosis and management of patients (2). The presence of the bony structures of the rib cage restricts the success of ultrasound imaging of the pleural surface to about 70% of the total (3). These issues, relating to limitations on the use of ultrasound in the thoracic area, have been known since the ʼ60s, a time when pioneering works were published using A-mode for exploring pleuro-pulmonary structures and, namely, pleural effusion (4), even in comparison with radiological imaging and with a greater sensitivity and specificity (5). Thereafter these advantages were established in the few subsequent years, with minimal further refinements despite the technology of ultrasound equipment has evolved considerably (6, 7): the value of ultrasound examination of the pleura and lungs remains highly underestimated to this day, and overstatements (8) and over- Mini-review...

show abstract

“…Thoracic ultrasonography can assess lesions smaller than 1 cm for the pulmonary parenchyma and less than 100 mL of pleural effusion. Due to no risk of irradiation and accessibility, the ultrasound examination can be performed on a daily basis [8][9][10][11][12][13][14]. Recent recommendations from both the European and American Societies of Hematology suggest the reduction of excessive, repeated, sometimes useless irradiation for hematological patients.…”

Section: Introductionmentioning

confidence: 99%

Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania

Frinc

Ilies

Zaharie

et al. 2017

Romanian Journal of Internal Medicine

View full text Add to dashboard Cite

In the past decade, there has been significant progress in clinical hematology with the discovery of targeted molecules and thus the achievement of both hematologic and molecular responses. Nevertheless, chemotherapy remains the treatment of choice for many types of hematological malignancies. Aggressive chemotherapy leads to immunosuppression, accompanied by a high rate of infections and an increased rate of treatment-related mortality. Invasive fungal infections as well as more common bacterial and viral infections are frequent in immunocompromised patients as they are difficult to diagnose and treat. Pleuropulmonary infections in immunocompromised patients are diagnosed using clinical examination, imaging and laboratory tests. Many laboratory tests are run for several days before a final result is given and are expensive. Computer tomography is a reliable technique, but it is encumbered by high irradiation and high cost, and can assess lesions larger than 1 cm. Transthoracic ultrasound is a modern method, used in the diagnostic algorithm of pleuropulmonary pathology. It allows the diagnosis of small lesions, can be performed at the patients' bedside, with acceptable costs and no irradiation. A fast, informed and accurate medical decision is essential for a favorable outcome in immunosuppressed patients with an adjacent infection. In the current case series we present the implementation of a new protocol for the follow-up of immunocompromised patients using transthoracic ultrasonography, of great potential use in the clinic.

show abstract

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Cited by 79 publications

References 50 publications

Characterization of the normal pulmonary surface and pneumonectomy space by reflected ultrasound

Characterization of the normal pulmonary surface and pneumonectomy space by reflected ultrasound

Transthoracic ultrasound for pleural effusion: traps and tricks

Transthoracic ultrasonography for the immunocompromised patient. A pilot project that introduces transthoracic ultrasonography for the follow-up of hematological patients in Romania

Contact Info

Product

Resources

About