ABSTRACT
Transthoracic ultrasonography is rapidly becoming a wellestablished and validated imaging modality in the hands of non-radiologists.1-7 Adequate pleural ultrasonography
can be performed by means of simple entry-level twodimensional (2D) equipment and by personnel with basic competency.1-4 Transthoracic ultrasonography complements real-time point-of-care clinical assessment of the respiratory system, is mobile, is inexpensive (in terms of acquisition of both equipment and consumables), and does
Introduction 222 Technical aspects 223
Basic physics and principles223 Ultrasound equipment 223 Patient positioning and scanning 224
Diagnostic pleural and chest wall ultrasonography 224
Normal chest 224 Chest wall and skeletal pathology 225 Pleural effusions226 Pleural thickening and tumors 227 Pneumothorax and hydropneumothorax228
Transthoracic ultrasonography beyond the pleura and chest wall 228
Pulmonary pathology228 Diaphragmatic pathology 229 Heart and upper abdomen 229
Ultrasound-guided interventions230 Principles 230 Thoracocentesis 230 Tube thoracostomy230 Closed pleural biopsy 230 Other ultrasound-guided transthoracic biopsies231
Basic competency in pleural ultrasonography231 Conclusions 231 References 231
not expose the patient or operator to radiation.1-4 Apart from numerous diagnostic applications, it may also guide an array of transthoracic interventional procedures. Moreover, ultrasound (US)-assisted procedures can be performed by a single clinician with no sedation and with minimal monitoring of the patient.2-4 e indications for pleural and chest wall US are summarized in Table 17.1. is chapter provides an overview of the general technical aspects of pleural ultrasonography, diagnostic application of ultrasonography in pleural diseases and diseases beyond the pleura, and US-guided interventions and concludes with suggested guidelines on basic competency from the perspective of the non-radiologist.
