Transthoracic US (TTUS) of the Chest Clinical Applications By Hussein Attia MD.

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Presentation transcript:

Transthoracic US (TTUS) of the Chest Clinical Applications By Hussein Attia MD

USES: Evaluation of 1- Peripheral parenchymal 2- Pleural 3- chest wall disease 4- Interventional procedures of the chest wall and pleural space

Parenchymal Diseases Pneumonia Pneumonia Neoplasms Neoplasms Heart failure Heart failure Infarct Infarct Round atelectasis Round atelectasis

Pleural Diseases Pleural effusion Pleural effusion Pneumothorax Pneumothorax Pleural mass Pleural mass Mesothelioma Mesothelioma

Chest wall abnormalities Chest wall tumors Chest wall tumors Rib fractures Rib fractures Other applications Diaphragmatic paralysis US Guided biopsy Thoracocentesis

Technique an instrumentations US 2-5 MHz curvilinear probe US 2-5 MHz curvilinear probe High resolution MHz High resolution MHz Gray scale and Color Doppler imaging Gray scale and Color Doppler imaging Patient position Patient position a)Raised arm position (in recumbence) b)Posterior chest in sitting, or lateral standing position

Sitting Lateral debcubitus Supine suprasternal approach Scanning positioning

Normal anatomy

Diseases of the Pleural space Anechoic effusion Complex septated pleural effusion Empyema

Diseases of the Pleural space Pleural thickening CT mesotheliomaUS mesothelioma

Diseases of the Lung Parenchyma Pneumonia and lung abscess Pneumonia and lung abscess US consolidation collapse of right lung lower lobe CD scan showing pulmonary artery branch supplying the collapsed segment

Central perihilar masses CT central neoplasmUS central neoplasm demonstrating both mass and lung consolidation M C

Neoplasm (Pancoast tumor) US transapical view Plain X ray AP view

Round atelectasis US: pleural invagination sign CT: round atelactasis within the left lung base

Diseases of the chest wall (lipoma) MRI: T1W Coronal US: 10 MHz

Diseases of the chest wall (Hemangioma) MRI: T2W Axial image US linear scan

Diseases of the chest wall (lymph nodes) US: Hyperplastic lymph nodeCD: Hyperplastic lymph node

Metastatic lymph nodes US: metastatic lymph nodePD: metastatic lymph node

Chest wall (rib fracture) US linear scan rib H

Mediastinal Intervention Biopsy of mediastinal masses

Pleural effusion and basal collapse

Normal CPA comet-tail artifact

THANK YOU