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Air and its Sonographic Appearance: Understanding the Artifacts.
Simran Buttar1, Denrick Cooper1, Patrick Olivieri1
1Department of Emergency Medicine, Division of Emergency Ultrasound, Mount Sinai St. Luke's Hospital, Mount Sinai West Hospital, New York, New York.
The Journal of Emergency Medicine
|April 5, 2017
Summary
Air artifacts on ultrasound, often overlooked, are crucial indicators of serious conditions like pneumothorax and necrotizing fasciitis. Recognizing these patterns aids emergency physicians in rapid diagnosis and management.
Area of Science:
- Emergency Medicine
- Radiology
- Medical Ultrasound
Background:
- Air is typically viewed as a limitation in sonographic imaging.
- Unusual presentations of air can signify diverse pathological conditions.
- Understanding air-induced artifacts is vital for accurate diagnoses.
Purpose of the Study:
- To highlight the diagnostic utility of air artifacts in emergency settings.
- To illustrate specific ultrasound findings associated with air in pathological locations.
- To emphasize the importance of recognizing these artifacts for emergency physicians.
Main Methods:
- Presentation of five emergency department cases.
- Visualization of air in abnormal locations using ultrasound.
- Description and discussion of sonographic findings.
Main Results:
- Ultrasound can rapidly identify air artifacts indicative of pneumothorax, pneumoperitoneum, necrotizing fasciitis, Fournier's gangrene, subcutaneous emphysema, and pneumomediastinum.
- Characteristic findings include irregular hyperechoic structures, "dirty shadowing," A-lines, and reduced visualization of deeper structures.
- These artifacts are due to air's impedance mismatch with human tissues.
Conclusions:
- Recognition of air artifacts on ultrasound is critical for emergency physicians.
- Knowledge of these sonographic patterns aids in diagnosis and further imaging decisions.
- Ultrasound is a valuable tool for identifying air in pathological conditions.