Artifacts, Noise and Interference: Much Ado about Ultrasound

Trovato, Guglielmo M.; Catalano, Daniela; Sperandeo, Marco; Graziano, Paolo

doi:10.1159/000375316

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Since from its beginning, more than 50 years ago, TUS was developed in association with echocardiography[ 102 - 106 ]. There where and there are limitations related to artefacts, to the type of transducers, to the setting of the equipments[ 107 ] and only recently a greater care is devoted in the investigation of the more suitable probes[ 108 ]. Considering the mostly debated area of the monitoring of congestion in heart failure patients, the use of pleural effusion as a reference remains still the most objective clue, if present[ 109 - 114 ].…”

Section: Assessment and Management Of Comprehensive Elective Workupsmentioning

confidence: 99%

Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Trovato¹,

Catalano²,

Trovato³

2016

WJR

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Imaging workup of patients referred for elective assessment of chest disease requires an articulated approach: Imaging is asked for achieving timely diagnosis. The concurrent or subsequent use of thoracic ultrasound (TUS) with conventional (chest X-rays-) and more advanced imaging procedures (computed tomography and magnetic resonance imaging) implies advantages, limitations and actual problems. Indeed, despite TUS may provide useful imaging of pleura, lung and heart disease, emergency scenarios are currently the most warranted field of application of TUS: Pleural effusion, pneumothorax, lung consolidation. This stems from its role in limited resources subsets; actually, ultrasound is an excellent risk reducing tool, which acts by: (1) increasing diagnostic certainty; (2) shortening time to definitive therapy; and (3) decreasing problems from blind procedures that carry an inherent level of complications. In addition, paediatric and newborn disease are particularly suitable for TUS investigation, aimed at the detection of congenital or acquired chest disease avoiding, limiting or postponing radiological exposure. TUS improves the effectiveness of elective medical practice, in resource-limited settings, in small point of care facilities and particularly in poorer countries. Quality and information provided by the procedure are increased avoiding whenever possible artefacts that can prevent or mislead the achievement of the correct diagnosis. Reliable monitoring of patients is possible, taking into consideration that appropriate expertise, knowledge, skills, training, and even adequate equipment’s suitability are not always and everywhere affordable or accessible. TUS is complementary imaging procedure for the radiologist and an excellent basic diagnostic tool suitable to be shared with pneumologists, cardiologists and emergency physicians.

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Section: Assessment and Management Of Comprehensive Elective Workupsmentioning

confidence: 99%

Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Trovato¹,

Catalano²,

Trovato³

2016

WJR

Self Cite

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“…Some part of the lung, where not overshadowed by ribs or other bones, such as scapula, is therefore clearly visible only if “consolidated”. This happens in atelectasis, pneumonia and cancer, provided that the mass or nodule strictly adheres close to pleura, becoming accessible to micro-invasive procedures[21-23]. There is no TUS established criterion for differentiating the nature of lung consolidation.…”

Section: Chest Ultrasound: the Thorax The Lung The Heartmentioning

confidence: 99%

Thoracic ultrasound: A complementary diagnostic tool in cardiology

Trovato

2016

WJC

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Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice. The concurrent use of thoracic ultrasound (TUS) is important, because, despite the evidence of the strict links between cardiac and respiratory medicine, heart and chest US imaging approaches are still separated. Actually, available expertise, knowledge, skills and training and equipment’s suitability are not equally fitting for heart or lung examination and not always already accessible in the same room or facility. Echocardiography is useful for study and monitoring of several respiratory conditions and even detection, so that this is nowadays an established functional complementary tool in pulmonary fibrosis and diffuse interstitial disease diagnosis and monitoring. Extending the approach of the cardiologist to lung and pleura will allow the achievement of information on pleural effusion, even minimal, lung consolidation and pneumothorax. Electrocardiography, pulse oximetry and US equipment are the friendly extension of the physical examination, if their use relies on adequate knowledge and training and on appropriate setting of efficient and working machines. Lacking these premises, overshadowing or misleading artefacts may impair the usefulness of TUS as an imaging procedure.

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“…We wish to add that the great variability of measures of lung US artifacts, particularly of B-lines but also of pleural line thickness, is due to many factors, which can be itemized as follows: proper setting of the equipment and features of the probe, inter-/intraobserver variability and subjective bias [5,6], age of patients. This bias is particularly relevant since difference of age is a commonly present confounding factor and associated with a very wide range of measures of both B-line number and pleural line thickness.…”

Section: Figmentioning

confidence: 99%