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Francisco MJ, de Lira EB, de Queiroz MRG. Point-of-Care in Clinical Practice: Consolidated Reality. Arq Bras Cardiol 2024; 121:e20230688. [PMID: 38451562 PMCID: PMC11081179 DOI: 10.36660/abc.20230688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 03/08/2024] Open
Affiliation(s)
- Miguel José Francisco
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Albert EinsteinSão PauloSPBrasilFaculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE) - Hospital Albert Einstein, São Paulo, SP – Brasil
| | - Edgar Bezerra de Lira
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Albert EinsteinSão PauloSPBrasilFaculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE) - Hospital Albert Einstein, São Paulo, SP – Brasil
| | - Marcos Roberto Gomes de Queiroz
- Faculdade Israelita de Ciências da Saúde Albert EinsteinHospital Albert EinsteinSão PauloSPBrasilFaculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE) - Hospital Albert Einstein, São Paulo, SP – Brasil
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2
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Huang L, Lin Y, Cao P, Zou X, Qin Q, Lin Z, Liang F, Li Z. Automated detection and segmentation of pleural effusion on ultrasound images using an Attention U-net. J Appl Clin Med Phys 2024; 25:e14231. [PMID: 38088928 PMCID: PMC10795456 DOI: 10.1002/acm2.14231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 11/19/2023] [Accepted: 11/21/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Ultrasonic for detecting and evaluating pleural effusion is an essential part of the Extended Focused Assessment with Sonography in Trauma (E-FAST) in emergencies. Our study aimed to develop an Artificial Intelligence (AI) diagnostic model that automatically identifies and segments pleural effusion areas on ultrasonography. METHODS An Attention U-net and a U-net model were used to detect and segment pleural effusion on ultrasound images of 848 subjects through fully supervised learning. Sensitivity, specificity, precision, accuracy, F1 score, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were used to assess the model's effectiveness in classifying the data. The dice coefficient was used to evaluate the segmentation performance of the model. RESULTS In 10 random tests, the Attention U-net and U-net 's average sensitivity of 97% demonstrated that the pleural effusion was well detectable. The Attention U-net performed better at identifying negative images than the U-net, which had an average specificity of 91% compared to 86% for the U-net. Additionally, the Attention U-net was more accurate in predicting the pleural effusion region because its average dice coefficient was 0.86 as opposed to the U-net's average dice coefficient of 0.82. CONCLUSIONS The Attention U-net showed excellent performance in detecting and segmenting pleural effusion on ultrasonic images, which is expected to enhance the operation and application of E-FAST in clinical work.
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Affiliation(s)
- Libing Huang
- Department of UltrasoundShenzhen Second People's HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhenChina
- Shenzhen University School of MedicineShenzhenChina
| | - Yingying Lin
- Department of Diagnostic RadiologyThe University of Hong KongHong KongChina
| | - Peng Cao
- Department of Diagnostic RadiologyThe University of Hong KongHong KongChina
| | - Xia Zou
- Department of UltrasoundShenzhen Second People's HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhenChina
| | - Qian Qin
- Shenzhen University School of MedicineShenzhenChina
| | - Zhanye Lin
- Department of UltrasoundLonggang District People's Hospital of ShenzhenShenzhenChina
| | - Fengting Liang
- Department of UltrasoundShenzhen Second People's HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhenChina
| | - Zhengyi Li
- Department of UltrasoundShenzhen Second People's HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhenChina
- Shenzhen University School of MedicineShenzhenChina
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3
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Di Serafino M, Dell’Aversano Orabona G, Caruso M, Camillo C, Viscardi D, Iacobellis F, Ronza R, Sabatino V, Barbuto L, Oliva G, Romano L. Point-of-Care Lung Ultrasound in the Intensive Care Unit-The Dark Side of Radiology: Where Do We Stand? J Pers Med 2023; 13:1541. [PMID: 38003856 PMCID: PMC10672373 DOI: 10.3390/jpm13111541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Patients in intensive care units (ICUs) are critically ill and require constant monitoring of clinical conditions. Due to the severity of the underlying disease and the need to monitor devices, imaging plays a crucial role in critically ill patients' care. Given the clinical complexity of these patients, who typically need respiratory assistance as well as continuous monitoring of vital functions and equipment, computed tomography (CT) can be regarded as the diagnostic gold standard, although it is not a bedside diagnostic technique. Despite its limitations, portable chest X-ray (CXR) is still today an essential diagnostic tool used in the ICU. Being a widely accessible imaging technique, which can be performed at the patient's bedside and at a low healthcare cost, it provides additional diagnostic support to the patient's clinical management. In recent years, the use of point-of-care lung ultrasound (LUS) in ICUs for procedure guidance, diagnosis, and screening has proliferated, and it is usually performed at the patient's bedside. This review illustrates the role of point-of-care LUS in ICUs from a purely radiological point of view as an advanced method in ICU CXR reports to improve the interpretation and monitoring of lung CXR findings.
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Affiliation(s)
- Marco Di Serafino
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Giuseppina Dell’Aversano Orabona
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Martina Caruso
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Costanza Camillo
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Daniela Viscardi
- Department of Intensive Care and Resuscitation, “Antonio Cardarelli” Hospital, 80131 Naples, Italy;
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Roberto Ronza
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Vittorio Sabatino
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Luigi Barbuto
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Gaspare Oliva
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
| | - Luigia Romano
- Department of General and Emergency Radiology, “Antonio Cardarelli” Hospital, 80131 Naples, Italy; (G.D.O.); (M.C.); (C.C.); (F.I.); (R.R.); (V.S.); (L.B.); (G.O.); (L.R.)
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Driban M, Dissak-Delon FN, Carvalho M, Mbianyor M, Etoundi-Mballa GA, Kingue T, Njock RL, Nkusu DN, Tsiagadigui JG, Puyana JC, Juillard C, Chichom-Mefire A, Christie SA. Failure to receive prescribed imaging is associated with increased early mortality after injury in Cameroon. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001951. [PMID: 37594917 PMCID: PMC10437996 DOI: 10.1371/journal.pgph.0001951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 07/24/2023] [Indexed: 08/20/2023]
Abstract
Despite having the highest rates of injury-related mortality in the world, trauma system capacity in sub-Saharan Africa remains underdeveloped. One barrier to prompt diagnosis of injury is limited access to diagnostic imaging. As part of a larger quality improvement initiative and to assist priority setting for policy makers, we evaluated trauma outcomes among patients who did and did not receive indicated imaging in the Emergency Department (ED). We hypothesize that receiving imaging is associated with increased early injury survival. We evaluated patterns of imaging performance in a prospective multi-site trauma registry cohort in Cameroon. All trauma patients enrolled in the Cameroon Trauma Registry (CTR) between 2017 and 2019 were included, regardless of injury severity. Patients prescribed diagnostic imaging were grouped into cohorts who did and did not receive their prescribed study. Patient demographics, clinical course, and outcomes were compared using chi-squared and Kruskal-Wallis tests. Multivariate logistic regression was used to explore associations between radiologic testing and survival after injury. Of 9,635 injured patients, 47.5% (4,574) were prescribed at least one imaging study. Of these, 77.8% (3,556) completed the study (COMPLETED) and 22.2% (1,018) did not receive the prescribed study (NC). Compared to COMPLETED patients, NC patients were younger (p = 0.02), male (p<0.01), and had markers of lower socioeconomic status (SES) (p<0.01). Multivariate regression adjusted for age, sex, SES, and injury severity demonstrated that receiving a prescribed study was strongly associated with ED survival (OR 5.00, 95% CI 3.32-7.55). Completing prescribed imaging was associated with increased early survival in injured Cameroonian patients. In a resource-limited setting, subsidizing access to diagnostic imaging may be a feasible target for improving trauma outcomes.
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Affiliation(s)
- Matthew Driban
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States of America
| | | | - Melissa Carvalho
- University of California–Los Angeles Department of Surgery, Program for the Advancement of Surgical Equity, Los Angeles, California, United States of America
| | - Mbiarikai Mbianyor
- University of California–Los Angeles Department of Surgery, Program for the Advancement of Surgical Equity, Los Angeles, California, United States of America
| | - Georges A. Etoundi-Mballa
- Ministry of Public Health of Cameroon Department of Disease Epidemic and Pandemic Control, Yaounde, Centre Region, Cameroon
| | - Thompson Kingue
- The Limbe Regional Hospital Hospital Administration, Limbe, Cameroon
| | - Richard L. Njock
- The Laquintinie Hospital of Douala Hospital Administration, Douala, Cameroon
| | - Daniel N. Nkusu
- The Catholic Hospital of Pouma Hospital Administration, Pouma, Cameroon
| | | | - Juan C. Puyana
- University of Pittsburgh Department of Trauma and Critical Care, Pittsburgh, Pennsylvania, United States of America
| | - Catherine Juillard
- University of California–Los Angeles Department of Surgery, Program for the Advancement of Surgical Equity, Los Angeles, California, United States of America
| | | | - S. Ariane Christie
- University of California–Los Angeles Department of Surgery, Program for the Advancement of Surgical Equity, Los Angeles, California, United States of America
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Demi L, Wolfram F, Klersy C, De Silvestri A, Ferretti VV, Muller M, Miller D, Feletti F, Wełnicki M, Buda N, Skoczylas A, Pomiecko A, Damjanovic D, Olszewski R, Kirkpatrick AW, Breitkreutz R, Mathis G, Soldati G, Smargiassi A, Inchingolo R, Perrone T. New International Guidelines and Consensus on the Use of Lung Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:309-344. [PMID: 35993596 PMCID: PMC10086956 DOI: 10.1002/jum.16088] [Citation(s) in RCA: 66] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/28/2022] [Accepted: 07/31/2022] [Indexed: 05/02/2023]
Abstract
Following the innovations and new discoveries of the last 10 years in the field of lung ultrasound (LUS), a multidisciplinary panel of international LUS experts from six countries and from different fields (clinical and technical) reviewed and updated the original international consensus for point-of-care LUS, dated 2012. As a result, a total of 20 statements have been produced. Each statement is complemented by guidelines and future developments proposals. The statements are furthermore classified based on their nature as technical (5), clinical (11), educational (3), and safety (1) statements.
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Affiliation(s)
- Libertario Demi
- Department of Information Engineering and Computer ScienceUniversity of TrentoTrentoItaly
| | - Frank Wolfram
- Department of Thoracic and Vascular SurgerySRH Wald‐Klinikum GeraGeraGermany
| | - Catherine Klersy
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | - Annalisa De Silvestri
- Unit of Clinical Epidemiology and BiostatisticsFondazione IRCCS Policlinico S. MatteoPaviaItaly
| | | | - Marie Muller
- Department of Mechanical and Aerospace EngineeringNorth Carolina State UniversityRaleighNorth CarolinaUSA
| | - Douglas Miller
- Department of RadiologyMichigan MedicineAnn ArborMichiganUSA
| | - Francesco Feletti
- Department of Diagnostic ImagingUnit of Radiology of the Hospital of Ravenna, Ausl RomagnaRavennaItaly
- Department of Translational Medicine and for RomagnaUniversità Degli Studi di FerraraFerraraItaly
| | - Marcin Wełnicki
- 3rd Department of Internal Medicine and CardiologyMedical University of WarsawWarsawPoland
| | - Natalia Buda
- Department of Internal Medicine, Connective Tissue Disease and GeriatricsMedical University of GdanskGdanskPoland
| | - Agnieszka Skoczylas
- Geriatrics DepartmentNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrzej Pomiecko
- Clinic of Pediatrics, Hematology and OncologyUniversity Clinical CenterGdańskPoland
| | - Domagoj Damjanovic
- Heart Center Freiburg University, Department of Cardiovascular Surgery, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Robert Olszewski
- Department of Gerontology, Public Health and DidacticsNational Institute of Geriatrics, Rheumatology and RehabilitationWarsawPoland
| | - Andrew W. Kirkpatrick
- Departments of Critical Care Medicine and SurgeryUniversity of Calgary and the TeleMentored Ultrasound Supported Medical Interventions Research GroupCalgaryCanada
| | - Raoul Breitkreutz
- FOM Hochschule für Oekonomie & Management gGmbHDepartment of Health and SocialEssenGermany
| | - Gebhart Mathis
- Emergency UltrasoundAustrian Society for Ultrasound in Medicine and BiologyViennaAustria
| | - Gino Soldati
- Diagnostic and Interventional Ultrasound UnitValledel Serchio General HospitalLuccaItaly
| | - Andrea Smargiassi
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
| | - Riccardo Inchingolo
- Pulmonary Medicine Unit, Department of Medical and Surgical SciencesFondazione Policlinico Universitario A. Gemelli IRCCSRomeItaly
- Department of Internal Medicine, IRCCS San Matteo Hospital FoundationUniversity of PaviaPaviaItaly
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6
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Désage AL, Mismetti V, Jacob M, Pointel S, Perquis MP, Morfin M, Guezara S, Langrand A, Galor C, Trouillon T, Diaz A, Karpathiou G, Froudarakis M. Place du pneumologue interventionnel dans la gestion des pleurésies métastatiques. Rev Mal Respir 2022; 39:778-790. [DOI: 10.1016/j.rmr.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
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7
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Jain R, Jana M, Gupta A, Naranje P. Ultrasonography in the Evaluation of Pediatric Chest "Masses": When to Consider? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:821-826. [PMID: 34173674 DOI: 10.1002/jum.15770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
Thoracic ultrasound is radiation-free, easily available, portable modality with added advantage of real-time assessment. It is useful in mediastinal lesions and peripheral lung, pleural and chest wall masses. Not only is it a valuable modality in differentiating solid from cystic lesion, it can also depict internal architecture without the use of contrast material. The added advantages of its use in children are the lack of ionizing radiation, and no need for sedation or general anesthesia in most cases. Although it has its limitations with a longer learning curve, it can act as a second-line modality to chest radiograph and adjunctive modality to CT in cases of a thoracic mass in a child.
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Affiliation(s)
- Rupali Jain
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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8
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Hussain K, Verma D, Firoz A, Namiq KS, Raza M, Haris M, Bouchama M, Khan S. Radiology and A Radiologist: A Keystone in the Turmoil of Trauma Setting. Cureus 2021; 13:e14267. [PMID: 33959449 PMCID: PMC8093107 DOI: 10.7759/cureus.14267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Traumatic injuries are one of the leading causes of morbidity and mortality. Precise diagnosis and management in the golden hour are key to decrease morbidity and mortality. History and physical examination alone are insufficient to avoid misdiagnosis. In this article, we tried to determine the role of a radiologist and an appropriate imaging modality in a trauma setting. We conducted a literature review of published research articles. We used the keywords imaging, trauma, imaging and trauma, and trauma imaging essentials were used on PubMed and Google Scholar. The articles published in the English language from 2015 to 2020 with full free text available were included. Using the medical subject heading (MeSH) strategy, "diagnostic imaging" (Major {Majr}) and "multiple trauma/diagnostic imaging" (Mesh) on PubMed, we identified 34 papers after applying the inclusion and exclusion criteria. Twenty articles were finally selected which included studies from 2015 to 2020 with articles focusing on the adult population and acute cases. A radiologist and imaging modalities are the essential parts of a trauma setting to lower morbidity and mortality. X-rays and Extended Focussed Assessment with Sonography for Trauma (eFAST) are the first-line imaging modality in the acute trauma setting. However, the CT scan is the most sensitive modality that should be done to avoid misdiagnosis depending upon the patient's history and physical examination.
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Affiliation(s)
- Khadija Hussain
- Radiology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Deepak Verma
- Internal Medicine/Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amena Firoz
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Karez S Namiq
- Oncology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maham Raza
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Muhammad Haris
- Internal Medicine, Royal Lancaster Infirmary, Health Education England North West, Lancaster, GBR.,Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Manel Bouchama
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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9
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Cole L, Pivetta M, Humm K. Diagnostic accuracy of a lung ultrasound protocol (Vet BLUE) for detection of pleural fluid, pneumothorax and lung pathology in dogs and cats. J Small Anim Pract 2021; 62:178-186. [PMID: 33496045 DOI: 10.1111/jsap.13271] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the accuracy of the lung ultrasound protocol Vet BLUE, using thoracic CT as the reference standard, for the detection of thoracic pathology in dogs and cats. MATERIALS AND METHODS Animals that had thoracic ultrasound and thoracic CT were prospectively recruited between May 2017 and September 2018. The Vet BLUE protocol was performed on animals at the time of admission by veterinarians with basic training in emergency ultrasound. A board-certified radiologist, blinded to the Vet BLUE findings, reviewed the CT images. RESULTS CT was abnormal in 64.5% (20/31) animals. The number of CT sites positive for alveolar-interstitial syndrome was 24.2% (60/248). When using CT as the reference standard, detection of ≥3 B lines with thoracic ultrasound had a sensitivity of 18.33% and specificity of 98.4% for detection of site specific alveolar-interstitial syndrome. The sensitivity of Vet BLUE to detect alveolar-interstitial syndrome increased to 56.9% when including the presence of any B line as abnormal. Overall accuracy for detection of alveolar-interstitial syndrome based on these two criteria was 79% and 73%, respectively. Vet BLUE correctly identified consolidation in 58.3% (14/24) sites, pleural effusion in 66.6% (2/3) cases, pneumothorax in 33.3% (1/3) cases and intrathoracic mass in 25% (1/4) cases. CLINICAL SIGNIFICANCE The Vet BLUE protocol is a useful technique to detect alveolar-interstitial syndrome and other thoracic pathology but should not be used as a sole imaging method. Detection of ≥3 B lines is highly suggestive of alveolar-interstitial syndrome and warrants further diagnostics.
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Affiliation(s)
- L Cole
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK
| | - M Pivetta
- Antech Imaging Services, Irvine, CA, 92614, USA
| | - K Humm
- Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, UK
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10
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Karakala N, Córdoba D, Chandrashekar K, Lopez-Ruiz A, Juncos LA. Point-of-Care Ultrasound in Acute Care Nephrology. Adv Chronic Kidney Dis 2021; 28:83-90. [PMID: 34389140 DOI: 10.1053/j.ackd.2021.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/18/2021] [Accepted: 06/03/2021] [Indexed: 12/23/2022]
Abstract
The use of point-of-care ultrasound (POCUS) is rapidly increasing in nephrology. It provides the opportunity to obtain complementary information that is more accurate than the classic physical examination. One can quickly follow the physical examination with a systematic POCUS evaluation of the kidneys, ureter bladder, inferior vena cava, heart, and lungs, which can provide diagnostic information and an accurate assessment of the patient's hemodynamics and volume status. Moreover, because it is safe and relatively easy to perform, it can be performed in a repeated manner as often as necessary so that the physician can reassess the patient's hemodynamics and volume status and adjust their therapy accordingly, permitting a more personalized approach to patient care (rather than blindly following protocols), especially to patients in acute care nephrology. Despite these advantages, nephrologists have been slow to adopt this diagnostic modality, perhaps because of lack of expertise. This review will provide an overview of the most commonly used POCUS examinations performed by nephrologists in the acute care setting. Its aim is to spark interest in in POCUS and to lay the foundation for readers to pursue more advanced training so that POCUS becomes a readily available tool in your diagnostic arsenal.
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11
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The role of point of care ultrasound in radiology department: update and prospective. A statement of Italian college ultrasound. Radiol Med 2020; 126:636-641. [PMID: 33146845 DOI: 10.1007/s11547-020-01301-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
Ultrasound, in its new point-of-care conception, has been called the stethoscope of the future. Goal-directed bedside ultrasound examination, performed by a healthcare provider to answer a specific diagnostic question or guide an invasive procedure, is currently revolutionizing medical practice. It is used by various specialties in multiple clinical contexts for procedural, diagnostic, and screening applications. Point-of-care ultrasound is also a strategic technique in clinical radiology; it brings the radiologist closer to the patient (in interaction and understanding) like interventional and angiography procedures and, as an integrative imaging modality, is a vital radiological tool for decision-making in many situations. In this commentary, we present our observations on the use of ultrasound, in a sincere appeal to refrain from omitting ultrasound as a diagnostic technique in this era of deep professional change, in which radiologists must return to being a true clinical semiologist.
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12
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Yassa M, Mutlu MA, Kalafat E, Birol P, Yirmibeş C, Tekin AB, Sandal K, Ayanoğlu E, Yassa M, Kılınç C, Tug N. How to perform and interpret the lung ultrasound by the obstetricians in pregnant women during the SARS-CoV-2 pandemic. Turk J Obstet Gynecol 2020; 17:225-232. [PMID: 33072428 PMCID: PMC7538823 DOI: 10.4274/tjod.galenos.2020.93902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
Objective: Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians. Materials and Methods: LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern. Results: In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described. Conclusion: The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.
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Affiliation(s)
- Murat Yassa
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Memiş Ali Mutlu
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Erkan Kalafat
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Pınar Birol
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Cihangir Yirmibeş
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Arzu Bilge Tekin
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Kemal Sandal
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Esra Ayanoğlu
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Mahmut Yassa
- Selahaddin Eyyubi State Hospital, Clinic of Obstetrics and Gynecology, Diyarbakır, Turkey
| | - Ceyhun Kılınç
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Niyazi Tug
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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13
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Affiliation(s)
- Miguel José Francisco Neto
- Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE) - Hospital Albert Einstein, São Paulo, SP, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brasil. E-mail:
| | - Marcos Roberto Gomes de Queiroz
- Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE) - Hospital Albert Einstein, São Paulo, SP, Brasil. E-mail:
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14
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de Farias LDPG, Fonseca EKUN, Strabelli DG, Loureiro BMC, Neves YCS, Rodrigues TP, Chate RC, Nomura CH, Sawamura MVY, Cerri GG. Imaging findings in COVID-19 pneumonia. Clinics (Sao Paulo) 2020; 75:e2027. [PMID: 32578826 PMCID: PMC7297525 DOI: 10.6061/clinics/2020/e2027] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/19/2020] [Indexed: 12/21/2022] Open
Abstract
The coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan city and was declared a pandemic in March 2020. Although the virus is not restricted to the lung parenchyma, the use of chest imaging in COVID-19 can be especially useful for patients with moderate to severe symptoms or comorbidities. This article aimed to demonstrate the chest imaging findings of COVID-19 on different modalities: chest radiography, computed tomography, and ultrasonography. In addition, it intended to review recommendations on imaging assessment of COVID-19 and to discuss the use of a structured chest computed tomography report. Chest radiography, despite being a low-cost and easily available method, has low sensitivity for screening patients. It can be useful in monitoring hospitalized patients, especially for the evaluation of complications such as pneumothorax and pleural effusion. Chest computed tomography, despite being highly sensitive, has a low specificity, and hence cannot replace the reference diagnostic test (reverse transcription polymerase chain reaction). To facilitate the confection and reduce the variability of radiological reports, some standardizations with structured reports have been proposed. Among the available classifications, it is possible to divide the radiological findings into typical, indeterminate, atypical, and negative findings. The structured report can also contain an estimate of the extent of lung involvement (e.g., more or less than 50% of the lung parenchyma). Pulmonary ultrasonography can also be an auxiliary method, especially for monitoring hospitalized patients in intensive care units, where transfer to a tomography scanner is difficult.
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Affiliation(s)
- Lucas de Pádua Gomes de Farias
- Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Daniel Giunchetti Strabelli
- Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Bruna Melo Coelho Loureiro
- Instituto do Cancer do Estado de São Paulo (ICESP), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Yuri Costa Sarno Neves
- Instituto do Cancer do Estado de São Paulo (ICESP), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Thiago Potrich Rodrigues
- Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Rodrigo Caruso Chate
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Cesar Higa Nomura
- Instituto do Coracao (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Márcio Valente Yamada Sawamura
- Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Giovanni Guido Cerri
- Instituto de Radiologia (InRad), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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15
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The lung ultrasound: facts or artifacts? In the era of COVID-19 outbreak. Radiol Med 2020; 125:738-753. [PMID: 32535787 PMCID: PMC7293437 DOI: 10.1007/s11547-020-01236-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Abstract
Ultrasound is the most disruptive innovation in intensive care life, above all in this time, with a high diagnostic value when applied appropriately. In recent years, point-of-care lung ultrasound has gained significant popularity as a diagnostic tool in the acutely dyspnoeic patients. In the era of Sars-CoV-2 outbreak, lung ultrasound seems to be strongly adapting to the follow-up for lung involvement of patients with ascertaining infections, till to be used, in our opinion emblematically, as a screening test in suspected patients at the emergency triage or at home medical visit. In this brief review, we discuss the lung ultrasound dichotomy, certainties and uncertainties, describing its potential role in validated clinical contexts, as a clinical-dependent exam, its limits and pitfalls in a generic and off-label clinical context, as a virtual anatomical-dependent exam, and its effects on the clinical management of patients with COVID-19.
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16
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Grune J, Beyhoff N, Hegemann N, Lauryn JH, Kuebler WM. From bedside to bench: lung ultrasound for the assessment of pulmonary edema in animal models. Cell Tissue Res 2020; 380:379-392. [PMID: 32009189 PMCID: PMC7210222 DOI: 10.1007/s00441-020-03172-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023]
Abstract
Traditionally, the lung has been excluded from the ultrasound organ repertoire and, hence, the application of lung ultrasound (LUS) was largely limited to a few enthusiastic clinicians. Yet, in the last decades, the recognition of the previously untapped diagnostic potential of LUS in intensive care medicine has fueled its widespread use as a rapid, non-invasive and radiation-free bedside approach with excellent diagnostic accuracy for many of the most common causes of acute respiratory failure, e.g., cardiogenic pulmonary edema, pneumonia, pleural effusion and pneumothorax. Its increased clinical use has also incited attention for the potential usefulness of LUS in preclinical studies with small animal models mimicking lung congestion and pulmonary edema formation. Application of LUS to small animal models of pulmonary edema may save time, is cost-effective, and may reduce the number of experimental animals due to the possibility of serial evaluations in the same animal as compared with traditional end-point measurements. This review provides an overview of the emerging field of LUS with a specific focus on its application in animal models and highlights future perspectives for LUS in preclinical research.
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Affiliation(s)
- Jana Grune
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Berlin, 10117, Berlin, Germany
| | - Niklas Beyhoff
- German Centre for Cardiovascular Research (DZHK), partner site Berlin, 10117, Berlin, Germany.,Institute of Pharmacology, Center for Cardiovascular Research, Charité-Universitätsmedizin Berlin, Hessische St 3-4, 10115, Berlin, Germany
| | - Niklas Hegemann
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Berlin, 10117, Berlin, Germany.,Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, 13353, Berlin, Germany
| | - Jonathan H Lauryn
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), partner site Berlin, 10117, Berlin, Germany
| | - Wolfgang M Kuebler
- Institute of Physiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. .,German Centre for Cardiovascular Research (DZHK), partner site Berlin, 10117, Berlin, Germany. .,The Keenan Research Centre for Biomedical Science at St. Michael's, Toronto, Canada. .,Departments of Surgery and Physiology, University of Toronto, Toronto, Canada.
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17
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Chiappetta M, Iaffaldano A, Petracca Ciavarella L, Meacci E, Margaritora S. Chest ultrasound: enhanced recovery after surgery (ERAS) best friend in general thoracic surgery. J Thorac Dis 2019; 11:S2026-S2027. [PMID: 31632816 DOI: 10.21037/jtd.2019.08.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Marco Chiappetta
- Universita Cattolica del Sacro Cuore, Rome, Italy.,Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Amedeo Iaffaldano
- Universita Cattolica del Sacro Cuore, Rome, Italy.,Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Leonardo Petracca Ciavarella
- Universita Cattolica del Sacro Cuore, Rome, Italy.,Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Elisa Meacci
- Universita Cattolica del Sacro Cuore, Rome, Italy.,Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Stefano Margaritora
- Universita Cattolica del Sacro Cuore, Rome, Italy.,Thoracic Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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18
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Wei X, Li S, Cheng S, Qiu L, Che G. Does daily chest ultrasound in the postoperative period contribute to an enhanced recovery after surgery pathway for patients undergoing general thoracic surgery? J Thorac Dis 2019; 11:S1246-S1249. [PMID: 31245099 DOI: 10.21037/jtd.2019.02.56] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xin Wei
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China.,Department of Ultrasound, Deyang People's Hospital, Deyang 618000, China
| | - Shuangjiang Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Shan Cheng
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Li Qiu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
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19
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Ünal E, Karcaaltincaba M, Akpinar E, Ariyurek OM. The imaging appearances of various pericardial disorders. Insights Imaging 2019; 10:42. [PMID: 30927107 PMCID: PMC6441059 DOI: 10.1186/s13244-019-0728-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 03/07/2019] [Indexed: 12/15/2022] Open
Abstract
The pericardium could be involved in a variety of clinical disorders. The imaging findings are not specific for an individual pathology in most of the cases; however, patient’s clinical history may guide radiologist to a definitive diagnosis. Congenital absence of the pericardium could be recognized with the imaging appearance of interposed lung tissue between the main pulmonary artery and aorta. Pericardial effusion is a non-specific condition that may occur due to inflammatory, infectious, and neoplastic disorders. Cardiac tamponade may occur in case of massive or rapid accumulation of fluid in the pericardial sac. Pericardial calcification is a common and easily identified entity on a computed tomography (CT) scan. Presence of calcification and/or fibrosis may result in pericardial constriction. Nevertheless, the pulsation of an adjacent coronary artery may prevent calcification formation in a focal area and consequently may result in pericardial diverticulum containing epicardial fat and coronary artery. The imaging findings encountered in patients with pericardial hydatid disease and Erdheim-Chester disease may mimic those of pericardial neoplasia. Pericardial adhesions and pedicled fat flaps may cause confusion on a CT scan in the post-surgical period following cardiac surgery. Pericardial fat necrosis can be diagnosed by CT in patients with chest pain. The radiologists should be familiar with the medical devices placed in pericardial space for certain individual indications. A pericardial patch and temporary epicardial pacemaker wires could be identified on a CT scan.
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Affiliation(s)
- Emre Ünal
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | | | - Erhan Akpinar
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey
| | - Orhan Macit Ariyurek
- Department of Radiology, School of Medicine, Hacettepe University, 06100, Ankara, Turkey.
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20
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Sabri YY, Hafez MA, Kamel KM, Abbas DA. Evaluating the role of ultrasound in chest trauma: Common complications and computed tomography comparative evaluation. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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21
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Toma TP, Trigiani M, Zanforlin A, Inchingolo R, Zanobetti M, Sammicheli L, Conte EG, Buggio G, Villari L, Corbetta L, Marchetti G. Competence in thoracic ultrasound. Panminerva Med 2018; 61:344-366. [PMID: 30486618 DOI: 10.23736/s0031-0808.18.03577-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ultrasound examination is traditionally considered a safe and repeatable exam, but its use is highly operator-dependent. Because of this, lack of sufficient operator skills could lead to diagnostic errors and damage to patient safety related to unnecessary tests or interventional procedures. The indications for lung ultrasound include: diagnosis, quantification, and follow-up of different conditions for which acute respiratory failure or chest pain are the main clinical presentation. Clinicians should have theoretical and practical knowledge on: physics and technology of ultrasound, indications and methodology of ultrasound examination, normal thoracic anatomy identification by echography, and detection of signs of pleuro-pulmonary pathology. Consequently, according to international recommendations, core basic skills and minimum training recommendations for the practice of medical ultrasound and image acquisition are needed to ensure competence of clinicians using ultrasound.
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Affiliation(s)
- Tudor P Toma
- University Hospital Lewisham, Greenwich NHS Trust, London, UK -
| | - Marco Trigiani
- Division of Interventional Pulmonology, Department of Cardiothoracic and Vascular Disease, Careggi University Hospital, Florence, Italy
| | | | - Riccardo Inchingolo
- Department of Respiratory Medicine, A. Gemelli University Hospital, Sacred Heart Catholic University, Rome, Italy
| | - Mauro Zanobetti
- Department of Emergency Medicine, Careggi University Hospital, Florence, Italy
| | - Lucia Sammicheli
- Sub-intensive Unit, Department of Emergency Medicine, Careggi University Hospital, Florence, Italy
| | - Emanuele G Conte
- Department of Respiratory Medicine, C. e G. Mazzoni Hospital, Ascoli Piceno, Italy
| | - Giuseppe Buggio
- Service of Pneumology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Liliana Villari
- Division of Pneumology, AUSL Toscana Nord-Ovest, Apuane Hospital, Massa, Italy
| | - Lorenzo Corbetta
- Unit of Interventional Pulmonology, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Florence, Italy
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22
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Royse C, Canty D, Sessler D. Perioperative ultrasound-assisted clinical evaluation - A case based review. Australas J Ultrasound Med 2018; 21:204-218. [PMID: 34760525 PMCID: PMC8409857 DOI: 10.1002/ajum.12113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Ultrasound is increasingly being adopted into anaesthesia and intensive care practice. The range of ultrasound examination has also increased from transoesophageal echocardiography in cardiac surgery and ultrasound-guided nerve blocks and vascular access, to examination of the heart, lungs, abdomen and deep veins. Typically, the use of ultrasound is focused or basic, designed to be performed by the anaesthetist at the patient's bedside in real time to answer clinical questions and to direct therapy. Ultrasound is not performed in isolation, but used to complement clinical evaluation, and accordingly can be considered as 'ultrasound-assisted perioperative evaluation'. Whilst there is good evidence that ultrasound improves diagnostic accuracy and in turn alters management, there are few data examining whether ultrasound leads to improved clinical outcomes. This review will examine multiple uses of perioperative ultrasound with case studies to illustrate potential utility.
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Affiliation(s)
- Colin Royse
- Department of SurgeryLevel 6, Centre for Medical ResearchUniversity of Melbourne300 Grattan StreetParkvilleVictoria3050Australia
- Department of Anaesthesia and Pain ManagementWard 3 NorthRoyal Melbourne Hospital300 Grattan StreetParkvilleVictoria3050Australia
| | - David Canty
- Department of SurgeryLevel 6, Centre for Medical ResearchUniversity of Melbourne300 Grattan StreetParkvilleVictoria3050Australia
- Department of Anaesthesia and Pain ManagementWard 3 NorthRoyal Melbourne Hospital300 Grattan StreetParkvilleVictoria3050Australia
- Department of MedicineMonash UniversityScenic Blvd & Wellington RoadClaytonVictoria3050Australia
- Department of Anaesthesia and Perioperative Medicine3rd FloorMonash Medical Centre246 Clayton RoadMelbourneVictoria3168Australia
| | - Daniel Sessler
- Department of Outcomes ResearchAnesthesiology InstituteCleveland ClinicClevelandOhioUSA
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23
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Chest Ultrasonography in Modern Day Extreme Settings: From Military Setting and Natural Disasters to Space Flights and Extreme Sports. Can Respir J 2018; 2018:8739704. [PMID: 29736195 PMCID: PMC5875054 DOI: 10.1155/2018/8739704] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/02/2018] [Accepted: 01/15/2018] [Indexed: 12/31/2022] Open
Abstract
Chest ultrasonography (CU) is a noninvasive imaging technique able to provide an immediate diagnosis of the underlying aetiology of acute respiratory failure and traumatic chest injuries. Given the great technologies, it is now possible to perform accurate CU in remote and adverse environments including the combat field, extreme sport settings, and environmental disasters, as well as during space missions. Today, the usage of CU in the extreme emergency setting is more likely to occur, as this technique proved to be a fast diagnostic tool to assist resuscitation manoeuvres and interventional procedures in many cases. A scientific literature review is presented here. This was based on a systematic search of published literature, on the following online databases: PubMed and Scopus. The following words were used: "chest sonography," " thoracic ultrasound," and "lung sonography," in different combinations with "extreme sport," "extreme environment," "wilderness," "catastrophe," and "extreme conditions." This manuscript reports the most relevant usages of CU in the extreme setting as well as technological improvements and current limitations. CU application in the extreme setting is further encouraged here.
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24
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Fonseca EKUN, Castro ADAE, Sameshima YT. Pneumothorax: between the beach and the stratosphere. J Bras Pneumol 2018; 43:324-325. [PMID: 29365008 PMCID: PMC5687973 DOI: 10.1590/s1806-37562017000000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | - Adham do Amaral E Castro
- . Departamento de Diagnóstico por Imagem, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
| | - Yoshino Tamaki Sameshima
- . Departamento de Diagnóstico por Imagem, Hospital Israelita Albert Einstein, São Paulo (SP) Brasil
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25
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Savatmongkorngul S, Wongwaisayawan S, Kaewlai R. Focused assessment with sonography for trauma: current perspectives. Open Access Emerg Med 2017; 9:57-62. [PMID: 28794661 PMCID: PMC5536884 DOI: 10.2147/oaem.s120145] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Focused assessment with sonography for trauma (FAST) is a part of resuscitation of trauma patients recommended by international panel consensus. The purpose of FAST is to identify free fluid, which necessarily means blood in acute trauma patients. In this article, the authors focused on various aspects of FAST in the emergency department, prehospital care, pediatric setting, training and general pearls/pitfalls. Detailed techniques and interpretation of FAST are beyond the scope of this article.
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Affiliation(s)
| | - Sirote Wongwaisayawan
- Division of Emergency Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rathachai Kaewlai
- Division of Emergency Radiology, Department of Diagnostic and Therapeutic Radiology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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26
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Francisco MJ, Rahal A, Vieira FAC, Silva PSDD, Funari MBDG. Advances in lung ultrasound. EINSTEIN-SAO PAULO 2017; 14:443-448. [PMID: 27759836 PMCID: PMC5234763 DOI: 10.1590/s1679-45082016md3557] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 05/17/2016] [Indexed: 01/28/2023] Open
Abstract
Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established. Some scanning protocols have been used in patient management. The Blue, FALLS and C.A.U.S.E. protocols are examples of algorithms using artifact combinations to achieve accurate diagnoses. Combined chest ultrasonography and radiography are often sufficient to diagnose and manage lung and chest wall conditions. Chest ultrasonography is a highly valuable diagnostic tool for radiologists, emergency and intensive care physicians.
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Affiliation(s)
| | - Antonio Rahal
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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27
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Rambhia SH, D'Agostino CA, Noor A, Villani R, Naidich JJ, Pellerito JS. Thoracic Ultrasound: Technique, Applications, and Interpretation. Curr Probl Diagn Radiol 2016; 46:305-316. [PMID: 28185691 DOI: 10.1067/j.cpradiol.2016.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/09/2016] [Indexed: 11/22/2022]
Abstract
Thoracic ultrasound is used at the bedside in emergency and critical care settings. Advantages of ultrasound include rapid real-time, low-cost, diagnostic information that can direct patient care without the use of ionizing radiation. We describe methods on how to perform lung ultrasound, with the intent to educate the radiologist who might otherwise be relatively unfamiliar with thoracic sonography. We describe and depict the normal sonographic appearance of lung anatomy. We also show the sonographic appearance of a wide range of lung and pleural pathologies such as pneumonia, pneumothorax, as well as lung and pleural masses. We review various lines and signs described in the literature, such as A-lines, B-lines, the stratosphere sign, and the bat-wing sign. Finally, we correlate our findings with chest x-ray and computerized tomography to emphasize the anatomy.
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Affiliation(s)
- Suraj H Rambhia
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY.
| | - Catherine A D'Agostino
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY
| | - Ali Noor
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY
| | - Robert Villani
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY
| | - Jason J Naidich
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY
| | - John S Pellerito
- Department of Radiology, North Shore University Hospital, Northwell Health, Manhasset, NY
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Kaiser Ururahy Nunes Fonseca E, do Amaral E Castro A, Sameshima YT. Emergency Thoracic US. Radiographics 2016; 36:2238. [PMID: 27831841 DOI: 10.1148/rg.2016160152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Adham do Amaral E Castro
- Department of Imaging, Hospital Israelita Albert Einstein, Av Albert Einstein 627, Sao Paulo, SP 05652-900, Brazil
| | - Yoshino Tamaki Sameshima
- Department of Imaging, Hospital Israelita Albert Einstein, Av Albert Einstein 627, Sao Paulo, SP 05652-900, Brazil
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29
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Pleural ultrasound for clinicians. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2016.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Porcel JM. Pleural ultrasound for clinicians. Rev Clin Esp 2016; 216:427-435. [PMID: 27282205 DOI: 10.1016/j.rce.2016.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 05/09/2016] [Accepted: 05/09/2016] [Indexed: 01/13/2023]
Abstract
Pleural ultrasonography is useful for identifying and characterising pleural effusions, solid pleural lesions (nodules, masses, swellings) and pneumothorax. Pleural ultrasonography is also considered the standard care for guiding interventionist procedures on the pleura at the patient's bedside (thoracentesis, drainage tubes, pleural biopsies and pleuroscopy). Hospitals should promote the acquisition of portable ultrasound equipment to increase the patient's safety.
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Affiliation(s)
- J M Porcel
- Unidad de Medicina Pleural, Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Instituto de Investigación Biomédica de Lleida Fundación Dr. Pifarré (IRBLLEIDA), Lleida, España.
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