Color Doppler Sonographically Guided Transthoracic Needle Aspiration of Lung and Mediastinal Masses

Abstract

Objective. This study investigated the diagnostic value of color Doppler sonographically guided transthoracic needle aspiration in lung and mediastinal masses. Methods. B-mode and color Doppler sonographic images were obtained in 48 patients with mediastinal or peripheral pulmonary tumors. Color Doppler sonography was used to show the vascular structures before the transthoracic needle aspiration procedure. It was also used to locate the needle tip during the procedure by showing the twinkling sign. This maneuver was performed with motion of the inner stylet. Pathologic and microbiological examination of the aspirates was made. Results. Vascular structures were detected in 37 cases on color Doppler images and in 10 cases on B-mode images. Similarly, the needle tip was observed in 39 cases on color Doppler images but in only 9 cases on B-mode images. No complications were observed except partial pneumothorax in 2 cases. The method had sensitivity of 90.0%, specificity of 87.5%, a positive predictive value of 97.2%, a negative predictive value of 63.6%, and diagnostic accuracy of 89.6%. Conclusions. Color Doppler sonographically guided transthoracic needle aspiration is a safe diagnostic method in malignant lung tumors, especially peripheral tumors, because of its ability to differentiate vascular structures within a tumor before the transthoracic needle aspiration procedure. It provides additional information about the location of the needle tip.

Vibrating interventional device detection using real-time 3-D color Doppler

“…The "pump technique" is performed by repeatedly advancing and retracting either the device or a guide wire within the device to create motion that is detected by the ultrasound system. This technique is effective but limited because tip identification is not improved and the color Doppler signal is only present while the device is being manipulated [10]. The ColorMark (Echocath, Princeton, NJ) is an FDAapproved device that couples low-frequency vibrations (1 to 3 kHz) into an aspiration needle [11].…”

Subclavian artery laceration: A serious complication of needle decompression

“…The presence of lung‐sliding and comet‐tail artefacts effectively excludes the presence of pneumothorax at the point of sonographic interrogation. Furthermore, bedside ultrasound can be used to facilitate needle placement, avoid vascular structures and confirm the effectiveness of tension pneumothorax decompression 3,10,11 . Using bedside ultrasound also allows periodic re‐evaluation without repeat doses of ionizing radiation.…”

“…Furthermore, bedside ultrasound can be used to facilitate needle placement, avoid vascular structures and confirm the effectiveness of tension pneumothorax decompression. 3,10,11 Using bedside ultrasound also allows periodic re-evaluation without repeat doses of ionizing radiation. Consequently, it is a safe means for assessing increasing pneumothorax size or the development of complications, such as haemothorax.…”

Color Doppler US Pulmonary Artery Vessel Signal: A Sign for Predicting the Benign Lesions

“…Thus, previously pulmonary and bronchial angiograms were used to diagnose and differentiate lung cancers from benign lesions (Lyons and Vertova 1958;Ney et al 1972;Viamonte 1965). Among the imaging modalities used in chest medicine, color Doppler ultrasound (US) has been applied to assess the vessel signals in thoracic lesions (Gorg et al 2003;Gorguner et al 2003;Hsu et al 1998Hsu et al , 1996Yuan et al 2000). Thus, from our viewpoint and experience, color Doppler US, being able to assess the vessel signals of thoracic lesions, should be able to predict and differentiate benign lesions from lung cancers.…”