The effectiveness of ultrasound investigation of the chest

Abstract

Chest ultrasonography (CHUS) is a useful imaging tool for thoracic soft tissues, pleural space and adjacent processes in the lung parenchyma. Unlike conventional radiography, CT or MRI, this non-ionizing imaging method is operator created and is very useful in patients in intensive care units (ICU) because of its simplicity and reproducibility. The ICU patient can be examined in supine, lateral or partly lateral position with the convex small-radius ultrasound probes using intercostal spaces as an acoustic window. Supine analysis of the anterior chest wall rules out pneumothorax, while lateral approach detects clinically relevant pleural effusion and parenchymal consolidations. CHUS is the method of choice in detection, characterization and volume estimation of free and/or loculated pleural fluid. According to our own study results, pleural effusion is most readily detected and measured during expiration. In our study we found healthy individuals with variable amounts of physiological pleural fluid, therefore a positive result should not be taken as a sign of occult pleural disease. With CHUS we can explore and characterise lung consolidations from the moment they reach the visceral pleura. CHUS can also contribute important data in critically ill patients with pulmonary embolism. CHUS exploration of the diaphragm can reliably evaluate respiratory movements since even a substantial pleural effusion does not affect the amplitude of diaphragmatic excursion.