PURPOSE: To evaluate:1-Diagnostic role of transthoracic Doppler ultrasonography (US) in different pleural diseases.2-Diagnostic task of transthoracic Doppler US in peripheral pulmonary lesions.3-Diagnostic position of transthoracic Doppler US in interstitial pulmonary fibrosis.4-Role of transthoracic Doppler US in discrimination between benign and malignant lymphadenopathy.5-Diagnostic role of transthoracic Doppler US in separation between acute cadiogenic pulmonary edema and ARDS.6- Diagnostic role of transthoracic US guided needle biopsy.
METHODS: This work represented a prospective study that was performed at Assiut university hospital between May 2006 and January 2009. Transthoracic Doppler US was performed by a single operator with specific training in lung sonography on 360 patients with pleural effusion, 88 with pneumothorax, 54 with mesothelioma, 40 with pleural thickening, 134 with consolidation, 120 with interstitial pulmonary fibrosis,85 with peripheral lung cancer,84 with cardiogenic pulmonary edema ,25 with ARDS and 96 with cervical or axillary lymphadenopathy . The diagnostic yield of transthoracic Doppler US was compared with those of chest radiograph , multislice CT, Doppler echocardiography and/or histopathology . The diagnostic yield of US guided needle biopsy was compared with that of CT guided biopsy.
RESULTS: A high successful and diagnostic role was reported for trasthoracic Doppler US in diagnosis of pleural diseases, peripheral lung cancer, simple pneumonia, obstructive pneumonia, pulmonary embolism, differentiation between benign and malignant lung lesions ,discrimination between IPF and inflammatory non specific interstitial pulmonary fibrosis, separation between cardiogenic pulmonary edema and ARDS and demarcation between benign and malignant lymphadenopathy. The yield of US guided needle biopsy was significantly higher than CT guided biopsy with less recorded pneumothorax and hemoptysis.
CONCLUSION: Ultrasound has become a practical and essential tool for the pulmonologist in diagnosis of pleural diseases, parenchymal lung diseases with separation between benign and malignant lymphadenopathy. US guided needle biopsy has a high diagnostic yield with minimal complications.
CLINICAL IMPLICATIONS: The advantages of low-cost, bedside availability , no radiation exposure,light weight,real time monitoring and the progress in its successful application create transthoracic ultrasound an indispensable diagnostic tool in modern pulmonary medicine.
DISCLOSURE: Gamal Agmy, No Financial Disclosure Information; No Product/Research Disclosure Information