Transthoracic ultrasound for chest wall, pleura, and the peripheral lung
Thoracic ultrasonography can be performed by means of the most basic ultrasound (US) equipment. In healthy individuals, US can visualize the chest wall, the diaphragm and the pleura but not the lung parenchyma. The main domain of thoracic US is the investigation of chest wall abnormalities, pleural thickening and pleural tumours, and the qualitative and quantitative description of pleural effusions. US can visualize lung tumours, pulmonary consolidations and other parenchymal pulmonary processes provided they abut the pleura. US is the ideal tool to assist with thoracentesis and drainage of effusions. US-assisted fine needle aspiration and cutting needle biopsy of lesions arising from the chest wall, pleura and peripheral lung are safe and have a high yield in the hands of chest physicians. US may also guide aspiration and biopsy of diffuse pulmonary infiltrates, consolidations and lung abscesses, provided the pleura is abutted. Advanced applications of transthoracic US include the diagnosis of a pneumothorax and pulmonary embolism. Copyright © 2009 S. Karger AG, Basel.