[Application of ultrasound in differential diagnosis of pleurisy]

According to literature data, pleural exudate is diagnosed approximately in 10% of pulmological patients. The importance of differential diagnosis of pleuriesy is expained by variability of the diseases accompanied by pleural exudate. 146 patients with various diseases accompanied by pleural exudate were examined: 39 from them had pleural empyema, 53--diffuse pleurisy, 42--incapsulated pleurisy, and 12--tumors of the pleura. All the patients underwent ultrasound examination (USE) of the chest together with a routine roentgenography, as well as computed tomography. USE was performed on the. Toshiba and Hitachi egurpment, which work in real time regime with sectorial sensing element (3.5-5.0 mHz). The obtained data show, that USE is most effective diagnostic tool in incapsulated and diffuse liquor accumulations in pleural cavity. In 6 patients the diagnosis of pleuritis was possible only at USE of the pleural cavity. Evaluation of the structure of the liquor and detection of tumor conglomerates on parietal pleura have a substantial diagnostic value. It is noted that echotomographic picture might be insufficiently informative in some situations with a small length of the contact of the lesion with the thoracic wall (less than 3 cm) or thickness of pleural layers up to 4-5 mm, in the presence of artefacts due to pulmonary tissues and osteal structures of the thoracic wall (ribs, scapula, sternum).