Chest Sonography by Gebhard Mathis

By Gebhard Mathis

Chest sonography is a longtime process within the stepwise imaging prognosis of pulmonary and pleural disorder. it's the approach to option to distinguish among strong and liquid lesions and permits the investigator to make an unequivocal analysis with no exposing the sufferer to high priced and tense approaches. This publication provides the state-of-the-art in chest research via ultrasonography. a couple of first-class illustrations and the compact textual content supply concise and easy-to-assimilate information regarding the diagnostic strategy.

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In fact, sonography is now used as a diagnostic measure to clarify pleural 3 26 Chapter 3 • The Pleura 3 . Fig. 7 Very small, stripe-like postoperative pleural effusion in the rib-diaphragm angle. The distortion of the area of effusion during a dynamic examination contraindicates circumscribed pleural thickening effusions and also is a fixed element of guidelines issued by pneumological societies (Maskell and Butland 2003). Pleural effusions are echo-free since they are liquid formations. The pleura sharply delineates the effusions (Fig.

3 Solid Pleural Changes The only visible reactions of the pleura to disease are exudation of fluid and edema. Pleural edema can appear diffuse, circumscribed, band-like, nodular, regular, irregular, hypoechogenic, or complexly structured. If the lung is still shifting with respiration, the swelling can unambiguously be associated with the parietal or visceral pleura, depending on whether the lung is still moving or not. If the pleural sheets are adhered, the position of the former pleural cavity can often only be guessed at by means of a faintly echogenic, partly interrupted line.

Once malignancy has been proven, the progression of chest wall lesions under therapy can be monitored. Fractures of the ribs as well as the sternum can be visualized well by sonography. Fracture diagnosis by sonography is not only much more sensitive than with conventional X-rays but also allows accompanying softtissue lesions, hematomas and pleural effusions to be detected rapidly and reliably. References Bitschnau R, Gehmacher O, Kopf A, Scheier M, Mathis G (1997) Ultraschalldiagnostik von Rippen- und Sternumfrakturen.

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