Contrast-enhanced ultrasound guided pleural biopsy improves diagnostic confidence for pleural based lesions: a 3-year prospective study

Sun, Wenwen; Zhou, Yiming; Cong, Yang; Dong, Zhengwei; Zhang, Zhemin; Wang, Yin; Fan, Lin

doi:10.1186/s12890-021-01583-7

Cited by 10 publications

(2 citation statements)

References 20 publications

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“…In interventional radiology, US contrast agents can be administered intravenously or intracavitary. Intravenous CEUS applications can improve lesion detection and differentiate between solid enhancing components and non-enhancing areas, such as necrotic or cystic regions, thereby improving the diagnostic confidence of US-guided pleural biopsies [ 97 , 98 ]. For procedures guided by US, such as the drainage of pleural abscesses or empyema, intracavitary contrast agents can be invaluable in assessing drain positioning and characterising abscess formations, including features like multilocularity [ 97 ].…”

Section: Newer Tools In Imaging the Pleuramentioning

confidence: 99%

Imaging of pleural disease

Hassan,

Touman,

Grabczak

et al. 2024

Breathe

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The pleural space is a “potential” anatomical space which is formed of two layers: visceral and parietal. It normally contains a trace of fluid (∼10 mL in each hemithorax). Diseases of the pleura can manifest with thickening of the pleural membranes or by abnormal accumulation of air or liquid. Chest radiographs are often the first imaging tests to point to a pleural pathology. With the exception of pneumothorax, and due to the inherent limitations of chest radiographs, ultrasound and/or computed tomography are usually required to further characterise the pleural pathology and guide management. This review summarises the utility of different imaging tools in the management of pleural disease and discusses new and evolving tools in imaging of the pleura.

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Section: Newer Tools In Imaging the Pleuramentioning

confidence: 99%

Imaging of pleural disease

Hassan,

Touman,

Grabczak

et al. 2024

Breathe

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“…This technique entails the injection of an intravenous contrast agent (SonoVue; Bracco S.p.A., Milan, Italy) which not only allows for the more accurate detection of vasculature structures, but also for the identification of necrotic areas. [34] Basic 2D scanning afterwards at the site of intervention can also exclude bleeding within the pleural space, which would present as a "swirling" or "gradient" effect, as heavier, more echogenic material (red blood cells) is rapidly deposited in the dependent part of the collection. [28] Seeding of metastatic malignancy at sites of previous pleural intervention is a complication which occurs most frequently in malignant mesothelioma.…”

Section: Optimizing Patient Safetymentioning

confidence: 99%

Ultrasound-guided pleural biopsy

Boy

2022

Eurasian J Pulmonol

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A pleural exudate that remains undiagnosed after a combined clinical assessment, thoracentesis, and imaging requires a pleural biopsy for a definitive diagnosis. Thoracoscopy is often the first method of choice to obtain tissue as it offers greater sensitivity and there is a perception of less risk. However, with imaging guidance, closed pleural biopsy is a safe, affordable, and effective alternative to diagnose all forms of pleural disease. Ultrasound (US) has several benefits when compared with computed tomography for image-guided biopsy, as it is widely available, can be performed bedside, and does not expose the patient to radiation. If performed in optimal conditions, a transthoracic USguided closed pleural biopsy can yield results comparable to those of thoracoscopy and a marked reduction in the complication rate versus blind biopsy. Abrams and Tru-Cut needles are the most widely used for a closed pleural biopsy. Either may be used with real-time image guidance or with a free-hand image-assisted technique to harvest up to 6 separate tissue samples. The needle choice will depend on the morphology of the lesion observed on imaging. The Tru-Cut is generally preferred for mass lesions of the pleura or pleura that is >20 mm in thickness, and the Abrams for pleural thickening of <20 mm or radiologically normal pleura. A transthoracic US may be used to detect, rule out, and prevent complications, such as bleeding, solid organ injury, or pneumothorax. The ability to perform thoracic US is a necessary skill in current respiratory practice, and US-guided closed pleural biopsy has a critical role in diagnosis.

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