The role of chest ultrasonography in the management of respiratory diseases: document I

Smargiassi, Andrea; Inchingolo, Riccardo; Soldati, Gino; Copetti, Roberto; Marchetti, Giampietro; Zanforlin, Alessandro; Giannuzzi, Rosangela; Testa, Americo; Nardini, S; Valente, Salvatore

doi:10.1186/2049-6958-8-54

Cited by 68 publications

(48 citation statements)

References 22 publications

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“…Its role in different clinical settings has already been shown [1,2,3,4,5,6,7]. The difficulties in making this technique widely accepted are based on the ability of ultrasound to cross tissues and make a morphological analysis of anatomic structures.…”

Section: Introductionmentioning

confidence: 99%

Lung Ultrasonography May Provide an Indirect Estimation of Lung Porosity and Airspace Geometry

Soldati¹,

Smargiassi

Inchingolo

et al. 2014

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Background: Echographic vertical artifacts (B-lines) in chest ultrasonography have often been associated with pathological patterns. A scientifically sound explanation of these artifacts has not yet been proposed. Objectives: The ‘spongy' nature of the lung in its liquid and solid components and the changes that take place in peripheral airspace (PAS) geometry might be the key point to understanding these phenomena. Methods: Six excised right rabbit lungs were obtained. Each lung underwent direct ultrasound evaluation in two different conditions: at complete tissue elastic recoil volume and at pulmonary expansion volume achieved by applying a constant positive pressure of 12 cm H₂O. Lung volumes and densities were reported in both conditions. Histological examination was performed on three naturally collapsed lungs and on three lungs under positive pressure inflation after having been fixed in formalin solution. Results: Mean volumes of naturally collapsed lungs and fixed expanded lungs were 11.2 ± 0.36 and 44.83 ± 3.03 ml, respectively. Mean densities were 0.622 ± 0.016 and 0.155 ± 0.007 g/ml, respectively. Ultrasound evaluation of collapsed lungs showed dense vertical artifacts and a ‘white lung' pattern, while the evaluation of expanded lungs showed hyperechoic line and horizontal artifacts of reflection. Histological evaluation showed a different PAS geometry in collapsed lungs caused by alveolar size reduction and shape changes with unfolded and closed units modifying the peripheral porosity of the frothy nature of the lung. Conclusions: Airspace geometry, frothy nature and porosity are the determinants of the different behavior of ultrasound interacting with the subpleural lung parenchyma. Chest ultrasound may thus be interpreted as an indirect ‘estimator' of lung porosity.

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Section: Introductionmentioning

confidence: 99%

Lung Ultrasonography May Provide an Indirect Estimation of Lung Porosity and Airspace Geometry

Soldati¹,

Smargiassi

Inchingolo

et al. 2014

Respiration

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“…Moreover, it permits with high sensitivity the assessment of the so-called pleural "sliding sign", which represents the physiological movement of the lung on the parietal pleural surface during the respiratory activity (10,15). When present, this sign shows the absence of adhesions and the possibility of a pneumothorax to be induced and the thoracoscopy to be performed, even in the complete absence of pleural effusion.…”

Section: Medical Thoracoscopymentioning

confidence: 99%

“…Chest ultrasound (US) is very useful in assessing pleural effusions and can identify thickenings or nodules, although without specificity for MPM (10,11).…”

Section: Review Articlementioning

confidence: 99%

Endoscopic diagnosis and management of pleural effusion in malignant pleural mesothelioma

et al. 2018

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“…In a complex non-septated effusion there is echogenic material inside an anechoic effusion, whereas floating fibrin strands characterize complex septated effusions; both are always exudates. Finally, homogenously echogenic spaces in the pleura cavity are also always exudates and are seen in haemorrhagic effusions and empyema [9,10]. The ultrasonographic appearance of a pleural effusion can be helpful to a certain extent in distinguishing malignant from non-malignant aetiology.…”

Section: Us and Pleural Effusionmentioning

confidence: 99%

Percutaneous Ultrasonography as Imaging Modality and Sampling Guide for Pulmonologists

Stigt

Groen

2014

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Ultrasound (US) imaging is gradually progressing into common practice in contemporary pulmonology. Its main applications are to determine the presence and amount of pleural effusions and to guide subsequent treatment interventions. Guidelines recommend the use of US for these indications. Training programs are organized and competency levels are formulated. Image guidance with US to obtain specimens for pathologic and/or microbiological analysis is less extensively practiced by pulmonologists but it is an important tool for tumour staging and diagnosing diseases. Lung tumours in contact with the pleural surface, pleural thickenings, mediastinal tumours and chest wall tumours are conceivable indications for pulmonologists to approach with the help of US visualization. Moreover, sampling of chest disease-related extrathoracal lesions may also be regarded as the working field of the pulmonologist. For example, supraclavicular and axillar lymph node metastasis, and also soft tissue and bone metastases, are lesions encountered during dissemination tests. US-guided biopsy provides not only a diagnosis, but also gives information on the stage of disease in sometimes inaccessible primary lesions. US-guided sampling increases diagnostic efficacy and safety and enables very precise performance of fine-needle aspirations as well as tissue core biopsies.

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The role of chest ultrasonography in the management of respiratory diseases: document I

Cited by 68 publications

References 22 publications

Lung Ultrasonography May Provide an Indirect Estimation of Lung Porosity and Airspace Geometry

Lung Ultrasonography May Provide an Indirect Estimation of Lung Porosity and Airspace Geometry

Endoscopic diagnosis and management of pleural effusion in malignant pleural mesothelioma

Percutaneous Ultrasonography as Imaging Modality and Sampling Guide for Pulmonologists

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