Thoraxsonography--Part II: Peripheral pulmonary consolidation

Area of Science:

• Medical Imaging
• Pulmonology
• Diagnostic Ultrasound

Background:

• Pulmonary diseases often involve the pleura, necessitating accurate diagnostic methods.
• Ultrasound (US) is a valuable tool for identifying the causes of pleural and pulmonary lesions.

Purpose of the Study:

• To outline sonomorphological criteria for differentiating peripheral pulmonary consolidations.
• To assess the diagnostic accuracy of chest sonography for pulmonary embolism and US-guided biopsies.
• To evaluate the safety and utility of ultrasound in mediastinal examinations.

Main Methods:

• Analysis of sonomorphological features of pneumonic infiltration and pulmonary infarctions.
• Evaluation of diagnostic accuracy data for chest sonography in pulmonary embolism (85%-90%).
• Review of diagnostic yield (>90% for malignancies, 50%-83% for benign lesions) and complication rates (1%-4%) for US-guided transthoracic biopsy.
• Assessment of sonographic examinations of the mediastinum and the use of endoluminal US to overcome limitations.

Main Results:

• Specific sonomorphological criteria differentiate pulmonary consolidations (e.g., hypoechoic texture in pneumonia, triangular lesions in infarction).
• Chest sonography demonstrates high accuracy (85%-90%) for pulmonary embolism.
• US-guided biopsy is highly effective for malignancies and moderately for benign lesions with low complication rates.
• Mediastinal US provides excellent results (90-95%), with endoluminal US addressing anatomical limitations.

Conclusions:

• Ultrasound is a versatile and accurate imaging modality for various pulmonary and pleural conditions.
• It offers high diagnostic yield for biopsies and effective evaluation of the mediastinum.
• Color Doppler US enhances understanding of vascularity and pathophysiology.