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Inchingolo R, Zanforlin A, Buonsenso D, Perrone T, Torri E, Limoli G, Mossolani EE, Tursi F, Soldati G, Marchetti G, Carlucci P, Radovanovic D, Lohmeyer FM, Smargiassi A. Lung Ultrasound Signs: The Beginning. Part 3-An Accademia di Ecografia Toracica Comprehensive Review on Ultrasonographic Signs and Real Needs. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:629-641. [PMID: 38168739 DOI: 10.1002/jum.16397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/02/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024]
Abstract
Over the last 20 years, scientific literature and interest on chest/lung ultrasound (LUS) have exponentially increased. Interpreting mixed-anatomical and artifactual-pictures determined the need of a proposal of a new nomenclature of artifacts and signs to simplify learning, spread, and implementation of this technique. The aim of this review is to collect and analyze different signs and artifacts reported in the history of chest ultrasound regarding normal lung, pleural pathologies, and lung consolidations. By reviewing the possible physical and anatomical interpretation of these artifacts and signs reported in the literature, this work aims to present the AdET (Accademia di Ecografia Toracica) proposal of nomenclature and to bring order between published studies.
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Affiliation(s)
- Riccardo Inchingolo
- UOC Pneumologia, Dipartimento Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessandro Zanforlin
- Service of Pulmonology, Health District of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Bolzano-Bozen, Italy
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Tiziano Perrone
- Emergency Medicine Department, Humanitas Gavazzeni, Bergamo, Italy
| | - Elena Torri
- Emergency Medicine Department, Humanitas Gavazzeni, Bergamo, Italy
| | | | | | - Francesco Tursi
- Pulmonary Medicine Unit, Codogno Hospital, Azienda Socio Sanitaria Territoriale Lodi, Codogno, Italy
| | - Gino Soldati
- Ippocrate Medical Center, Castelnuovo di Garfagnana, Lucca, Italy
| | | | - Paolo Carlucci
- Department of Health Sciences, Università degli Studi di Milano, Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Dejan Radovanovic
- Division of Respiratory Diseases, Ospedale Luigi Sacco, Polo Universitario, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC), Università degli Studi di Milano, Milan, Italy
| | | | - Andrea Smargiassi
- UOC Pneumologia, Dipartimento Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Wang T, Du G, Fang L, Bai Y, Liu Z, Wang L. Value of ultrasonography in determining the nature of pleural effusion: Analysis of 582 cases. Medicine (Baltimore) 2022; 101:e30119. [PMID: 35984158 PMCID: PMC9388019 DOI: 10.1097/md.0000000000030119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
To explore the value of ultrasonography in the auxiliary diagnosis of pleural effusion, we retrospectively analyzed the ultrasonographic findings of 275 exudates and 307 transudates and summarized the ultrasonographic image features of pleural effusion according to patients' primary diseases. The findings of thoracic ultrasonography performed before the initial thoracentesis in 582 patients with subsequently confirmed exudative/transudative pleural effusion were analyzed with regard to the sonographic features of pleural effusion. In 275 cases with exudates, thoracic ultrasonography showed a complex septate appearance in 19 cases (6.9%), complex nonseptate appearance in 100 cases (36.4%), complex homogenous sign in 46 cases (16.7%), and pleural thickness > 3 mm in 105 cases. In contrast, in 307 patients with transudates, most patients (97.1%) had bilateral pleural effusion. Ultrasonographic images displayed anechoic appearance and absence of pleural thickening in a vast majority of cases (306, 99.7%; 301, 98%). These positive findings in the exudate were statistically higher than those in their counterparts (P < .05). In the empyema subgroup, the proportion of complex septate appearance, complex nonseptate appearance, complex homogenous sign, and pleural thickening was the highest, at 19/41, 12/41, 10/41, and 30/41, respectively. Ultrasonography is valuable in defining the nature of pleural effusion. Some sonographic features of pleural effusion, such as echogenicity, septation, and pleural thickening, may indicate a high risk of exudative pleural effusion.
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Affiliation(s)
- Ting Wang
- Department of Respiratory Medicine, Xi’an People’s Hospital (Xi’an No. 4 Hospital), Xi’an 710004, China
| | - Ge Du
- Department of Rehabilitation Center for Elderly, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
| | - Liping Fang
- Department of Respiratory Medicine, Xi’an People’s Hospital (Xi’an No. 4 Hospital), Xi’an 710004, China
| | - Yang Bai
- Department of Medical Ultrasonics, Xi’an People’s Hospital (Xi’an No. 4 Hospital), Xi’an 710004, China
| | - Zishuang Liu
- Department of Rehabilitation Center for Elderly, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China
- *Correspondence: Zishuang Liu, Department of Rehabilitation Center for Elderly, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China (e-mail: ); or Li Wang, Department of Radiology, Xi’an People’s Hospital (Xi’an No.4 Hospital), Xi’an 710004, China, Xi’an 710004, China (e-mail: )
| | - Li Wang
- Department of Radiology, Xi’an People’s Hospital (Xi’an No. 4 Hospital), Xi’an 710004, China
- *Correspondence: Zishuang Liu, Department of Rehabilitation Center for Elderly, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing 100144, China (e-mail: ); or Li Wang, Department of Radiology, Xi’an People’s Hospital (Xi’an No.4 Hospital), Xi’an 710004, China, Xi’an 710004, China (e-mail: )
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Palumbo MG, Quarato CMI, Lacedonia D, Lucia D, Simeone A, Di Micco C, De Cosmo S, Scioscia G, Foschino Barbaro MP, Sperandeo M. A Transthoracic Ultrasound-Guided Needle Biopsy Provided the Diagnosis for a Synovial Sarcoma of the Pleura. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2022. [DOI: 10.1177/87564793221100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A case report is presented of a 72-year-old woman with monophasic synovial sarcoma of the buttocks, diagnosed four years before. The tumor was treated with surgical removal followed by radiotherapy. The patient regularly underwent follow-up examinations and the last chest computed tomogram (CT) showed a left-sided pleural mass and ipsilateral effusion. The patient was admitted in hospital to obtain a specific histological diagnosis before treatment of chest pathology was initiated. An ultrasound (US)-guided fine needle aspiration biopsy (FNAB) of the pleural lesion and US-guided thoracentesis with drainage of blood serum pleural fluid were performed. The pathological examination of the lesion revealed a definitive diagnosis of synovial sarcoma of the pleura. For pleural-based lesions, the diagnostic accuracy of US-guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate, the absence of radiation exposure to patients, and a significantly reduced procedural time. The presence of pleural effusion creates a favorable acoustic window for US-guided biopsy of pleural lesion, which is useful for the diagnosis.
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Affiliation(s)
- Maria Giovanna Palumbo
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Institute of Respiratory Diseases, Policlinico Universitario Riuniti di Foggia, Foggia, Italy
| | - Carla Maria Irene Quarato
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Institute of Respiratory Diseases, Policlinico Universitario Riuniti di Foggia, Foggia, Italy
| | - Donato Lacedonia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Institute of Respiratory Diseases, Policlinico Universitario Riuniti di Foggia, Foggia, Italy
| | - Dimitri Lucia
- Unit of Pathology, IRCCS Fondazione “Casa Sollievo della Sofferenza,” San Giovanni Rotondo, Italy
| | - Anna Simeone
- Unit of Radiology, IRCCS Fondazione “Casa Sollievo della Sofferenza,” San Giovanni Rotondo, Italy
| | - Concetta Di Micco
- Unit of Oncology, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Salvatore De Cosmo
- Unit of Internal Medicine, IRCCS Fondazione Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giulia Scioscia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Institute of Respiratory Diseases, Policlinico Universitario Riuniti di Foggia, Foggia, Italy
| | - Maria Pia Foschino Barbaro
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Institute of Respiratory Diseases, Policlinico Universitario Riuniti di Foggia, Foggia, Italy
| | - Marco Sperandeo
- Unit of Interventional and Diagnostic Ultrasound of Internal Medicine, IRCCS Fondazione “Casa Sollievo della Sofferenza,” San Giovanni Rotondo, Italy
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