Sonography of the Pediatric Chest

Abstract

Traditionally, pediatric chest diseases are evaluated with chest radiography. Due to advancements in technology, the use of sonography has broadened. It has now become an established radiation‐free imaging tool that may supplement plain‐film findings and, in certain cases, the first‐line modality for evaluation of the pediatric chest. This pictorial essay will demonstrate the diagnostic potential of sonography, review a spectrum of pediatric chest conditions, and discuss their imaging features and clinical importance.

Neonatal and pediatric thoracic ultrasonography

“…The 'gliding' or 'sliding sign' can indicate the absence of pneumothorax with an accuracy close to 100%. Such a conclusion is further proven when the ring-down artifacts (B-lines) are found along with the comet tails, which move in sync with the child's breathing [9,10].…”

Reduced or Absent “Lung Sliding” ‐ A Novel Lung Ultrasound Sign of Pediatric Foreign Body Aspiration

“…An absence of the lung sliding sign is most frequently related to pneumothorax, which is understandable as this is one of the most urgent pulmonary diagnoses. However, we have an impression that other potential, underlying pulmonary pathologies, which can occur with the absence of lung sliding, might be ignored, considering that some of the latest review articles mention only pneumothorax in this context . The reality is considerably different, however, because in our 10‐year experience with LUS, which we perform almost daily, we have had the opportunity to see an absence of lung sliding or its reduction (in comparison to the contralateral side) many times, and in at least one half of those cases pneumothorax was not the final diagnosis.…”

The use of lung ultrasound compared to chest X‐ray to diagnose pneumothorax following the Nuss procedure for pectus excavatum repair in children

“…The technique described in this study also has the potential to be applied in the context of other pediatric cardiothoracic surgeries. 32,33 From the juridical point of view, if lung ultrasound is performed following a standardized approach, the images acquired and the report compiled can be attached to the medical record as part of the diagnostic pathway. In such cases, operators should always be certified, having completed basic or advanced courses for point-ofcare lung ultrasound.…”

“…Moreover, the present study validates the use of lung ultrasound after thoracoscopic surgery in a specific pediatric population where chest X‐ray has routinely been used to date. The technique described in this study also has the potential to be applied in the context of other pediatric cardiothoracic surgeries 32,33 …”