Download PDF
Ultraschall Med 2023; 44(06): 582-599
DOI: 10.1055/a-2010-7282
Continuing Medical Education

Ultrasound of the lung

Article in several languages: English | deutsch
Christoph F. Dietrich 
1   Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
,
Christian Görg
2   Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Germany
,
Rudolf Horn
3   Center da sandà Val Müstair, CH-7537 Sta. Maria
,
Helmut Prosch 
4   Abteilung für Allgemeine Radiologie und Kinderradiologie, Medizinische Universität Wien, Austria
,
Ehsan Safai Zadeh 
2   Interdisciplinary Center of Ultrasound Diagnostics, University Hospital Giessen and Marburg, Philipps University Marburg, Germany
,
Christian Jenssen 
5   Klinik für Innere Medizin, Krankenhaus Märkisch-Oderland, Strausberg/Wriezen, Germany
6   Brandenburgisches Institut für Klinischen Ultraschall an der Medizinischen Hochschule Brandenburg, Neuruppin, Germany
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

The CME review is intended to explain and discuss the clinical value of lung ultrasound but also to enable a pragmatically oriented approach by analyzing the clinical aspect. This includes knowledge of the pre-test probability, the acuteness of the disease, the current clinical situation, detection and/or characterization, initial diagnosis or follow up assessment and the peculiarities of exclusion diagnosis. Diseases of the pleura and lungs are described using these criteria with their direct and indirect sonographic signs and the specific clinical significance of ultrasound findings. The importance and criteria of conventional B-mode, color Doppler ultrasound with or without spectral analysis of the Doppler signal and contrast-enhanced ultrasound are discussed as well.

Key words

pleural effusion - pneumonia - guideline - lung embolism


Publication History

Article published online:
13 April 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Jaworska J, Buda N, Ciuca IM. et al. Ultrasound of the pleura in children, WFUMB review paper. Med Ultrason 2021; 23 (03) 339-347 DOI: 10.11152/mu-3058.
    CrossrefPubMedGoogle Scholar
  • 2 Dietrich CF, Buda N, Ciuca IM. et al. Lung ultrasound in children, WFUMB review paper (part 2). Med Ultrason 2021; 23 (04) 443-452 DOI: 10.11152/mu-3059.
    CrossrefPubMedGoogle Scholar
  • 3 Fang C, Jaworska J, Buda N. et al. Ultrasound of the chest and mediastinum in children, interventions and artefacts. WFUMB review paper (part 3). Med Ultrason 2022; 24: 65-67
    CrossrefPubMedGoogle Scholar
  • 4 Frohlich E, Beller K, Muller R. et al. Point of Care Ultrasound in Geriatric Patients: Prospective Evaluation of a Portable Handheld Ultrasound Device. Ultraschall in Med 2020; 41 (03) 308-316 DOI: 10.1055/a-0889-8070.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Mathis G, Horn R, Morf S. et al. WFUMB position paper on reverberation artefacts in lung ultrasound: B-lines or comet-tails?. Med Ultrason 2021; 23: 70-73
    CrossrefPubMedGoogle Scholar
  • 6 Findeisen H, Trenker C, Safai Zadeh E. et al. Further aspects concering peripheral lung carcinoma in CEUS. Ultraschall in der Medizin – European Journal of Ultrasound 2021; 42 (03) 323
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Safai Zadeh E, Beutel B, Dietrich CF. et al. Perfusion Patterns of Peripheral Pulmonary Lesions in COVID-19 Patients Using Contrast-Enhanced Ultrasound (CEUS): A Case Series. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2021; 40: 2403-2411
    CrossrefPubMedGoogle Scholar
  • 8 Safai Zadeh E, Dietrich CF, Kmoth L. et al. Peripheral Pulmonary Lesions in Confirmed Pulmonary Arterial Embolism: Follow-up Study of B-Mode Ultrasound and of Perfusion Patterns Using Contrast-Enhanced Ultrasound (CEUS). Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2022; 41 (07) 1713-1721 DOI: 10.1002/jum.15852.
    CrossrefPubMedGoogle Scholar
  • 9 Safai Zadeh E, Görg C, Dietrich CF. et al. Contrast-Enhanced Ultrasound for Evaluation of Pleural Effusion: A Pictorial Essay. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2022; 41: 485-503
    CrossrefPubMedGoogle Scholar
  • 10 Safai Zadeh E, Görg C, Prosch H. et al. WFUMB Technological Review: How to Perform Contrast-Enhanced Ultrasound of the Lung. Ultrasound Med Biol 2022; 48 (04) 598-616 DOI: 10.1016/j.ultrasmedbio.2021.11.014.
    CrossrefPubMedGoogle Scholar
  • 11 Safai Zadeh E, Huber KP, Dietrich CF. et al. The Value of Lung Ultrasound to Detect the Early Pleural and Pulmonary Pathologies in Nonhospitalized COVID-19-Suspected Cases in a Population with a Low Prevalence of COVID-19 Infection: A Prospective Study in 297 Subjects. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2022; 41 (06) 1397-1403 DOI: 10.1002/jum.15822.
    CrossrefPubMedGoogle Scholar
  • 12 Safai Zadeh E, Keber CU, Dietrich CF. et al. Perfusion Patterns of Peripheral Pulmonary Granulomatous Lesions Using Contrast-Enhanced Ultrasound (CEUS) and Their Correlation with Immunohistochemically Detected Vascularization Patterns. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2022; 41: 565-574
    CrossrefPubMedGoogle Scholar
  • 13 Safai Zadeh E, Weide J, Dietrich CF. et al. Diagnostic Accuracy of B-Mode- and Contrast-Enhanced Ultrasound in Differentiating Malignant from Benign Pleural Effusions. Diagnostics (Basel) 2021; 11: 1293
    CrossrefPubMedGoogle Scholar
  • 14 Alhyari A, Görg C, Dietrich CF. et al. Diagnostic Performance of Point Shear Wave Elastography Using Acoustic Radiation Force Impulse Technology in Peripheral Pulmonary Consolidations: A Feasibility Study. Ultrasound Med Biol 2022; 12 (02) 523
    PubMedGoogle Scholar
  • 15 Mathis G, Metzler J, Fussenegger D. et al. Sonographic observation of pulmonary infarction and early infarctions by pulmonary embolism. Eur Heart J 1993; 14: 804-808
    CrossrefPubMedGoogle Scholar
  • 16 Trenker C, Dohse M, Ramaswamy A. et al. Histological validation of pulmonary infarction detected with contrast-enhanced ultrasound in patients with negative computed tomography pulmonary angiogram: A case series. J Clin Ultrasound 2019; 47: 461-465
    CrossrefPubMedGoogle Scholar
  • 17 Trenker C, Apitzsch JC, Pastor S. et al. Detection of peripheral embolic consolidations using contrast-enhanced ultrasonography in patients with no evidence of pulmonary embolism on computed tomography: A pilot study. J Clin Ultrasound 2017; 45: 575-579
    CrossrefPubMedGoogle Scholar
  • 18 Ewig S, Kolditz M, Pletz M. et al. Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie – Update 2021. Pneumologie 2021; 75: 665-729
    Google Scholar
  • 19 Speidel V, Conen A, Gisler V. et al. Lung Assessment with Point-of-Care Ultrasound in Respiratory Coronavirus Disease (COVID-19): A Prospective Cohort Study. Ultrasound Med Biol 2021; 47: 896-901
    CrossrefPubMedGoogle Scholar
  • 20 Piscaglia F, Stefanini F, Cantisani V. et al. Benefits, Open questions and Challenges of the use of Ultrasound in the COVID-19 pandemic era. The views of a panel of worldwide international experts. Ultraschall in Med 2020; 41: 228-236
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Reissig A, Copetti R. Lung ultrasound in community-acquired pneumonia and in interstitial lung diseases. Respiration; international review of thoracic diseases 2014; 87: 179-189
    CrossrefPubMedGoogle Scholar
  • 22 Safai Zadeh E, Görg C, Prosch H. et al The Role of Thoracic Ultrasound for Diagnosis of Diseases of the Chest Wall, the Mediastinum and the Diaphragm – Narrative Review and Pictorial Essay. Diagnostics 2023, epub in advance
    PubMedGoogle Scholar
  • 23 Di Gennaro F, Pisani L, Veronese N. et al. Potential Diagnostic Properties of Chest Ultrasound in Thoracic Tuberculosis-A Systematic Review. International journal of environmental research and public health 2018; 15 (10) 2235
    CrossrefPubMedGoogle Scholar
  • 24 Safai Zadeh E, Alhyari A, Kroenig J. et al B-mode ultrasound and contrast-enhanced ultrasound for evaluation of pneumonia: A pictorial essay. AJUM 2023, epub in advance
    PubMedGoogle Scholar
  • 25 Yue Lee FC, Jenssen C, Dietrich CF. A common misunderstanding in lung ultrasound: the comet tail artefact. Med Ultrason 2018; 20: 379-384
    CrossrefPubMedGoogle Scholar
  • 26 Dietrich CF, Mathis G, Blaivas M. et al. Lung B-line artefacts and their use. J Thorac Dis 2016; 8: 1356-1365
    CrossrefPubMedGoogle Scholar
  • 27 Dietrich CF, Goudie A, Chiorean L. et al. Point of Care Ultrasound: A WFUMB Position Paper. Ultrasound Med Biol 2017; 43: 49-58
    CrossrefPubMedGoogle Scholar
  • 28 Dietrich CF, Bulla P, Dudwiesus H. Perspectives and Challenges of hand-held Ultrasound. Zeitschrift fur Gastroenterologie 2022; DOI: 10.1055/a-1901-9394.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Lacedonia D, Quarato CMI, Mirijello A. et al. COVID-19 Pneumonia: The Great Ultrasonography Mimicker. Front Med (Lausanne) 2021; 8: 709402
    CrossrefPubMedGoogle Scholar
  • 30 Volpicelli G, Gargani L, Perlini S. et al. Lung ultrasound for the early diagnosis of COVID-19 pneumonia: an international multicenter study. Intensive care medicine 2021; 47: 444-454
    CrossrefPubMedGoogle Scholar
  • 31 European Society of R. The role of lung ultrasound in COVID-19 disease. Insights into imaging 2021; 12: 81
    CrossrefPubMedGoogle Scholar
  • 32 Jiang M, Li C, Zheng L. et al. A biomarker-based age, biomarkers, clinical history, sex (ABCS)-mortality risk score for patients with coronavirus disease 2019. Ann Transl Med 2021; 9: 230
    CrossrefPubMedGoogle Scholar
  • 33 Dietrich CF, Douira-Khomsi W, Gharbi H. et al. Cystic echinococcosis, review and illustration of non-hepatic manifestations. Med Ultrason 2020; 22: 319-324
    CrossrefPubMedGoogle Scholar
  • 34 Acosta CM, Maidana GA, Jacovitti D. et al. Accuracy of transthoracic lung ultrasound for diagnosing anesthesia-induced atelectasis in children. Anesthesiology 2014; 120: 1370-1379
    CrossrefPubMedGoogle Scholar
  • 35 Görg C, Bert T, Kring R. Contrast-enhanced sonography of the lung for differential diagnosis of atelectasis. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 2006; 25: 35-39
    CrossrefPubMedGoogle Scholar
  • 36 Xu W, Wen Q, Zhang X. et al. The Application of Contrast Enhanced Ultrasound for Core Needle Biopsy of Subpleural Pulmonary Lesions: Retrospective Analysis in 92 Patients. Ultrasound Med Biol 2021; 47: 1253-1260
    CrossrefPubMedGoogle Scholar
  • 37 Yusuf GT, Fang C, Tran S. et al. A pictorial review of the utility of CEUS in thoracic biopsies. Insights into imaging 2021; 12: 9
    CrossrefPubMedGoogle Scholar
  • 38 Liang J, Wang D, Li H. et al. Contrast-enhanced ultrasound for needle biopsy of thoracic lesions. Oncol Lett 2020; 20: 75
    PubMedGoogle Scholar
  • 39 Hocke M, Ignee A, Topalidis T. et al. Contrast-enhanced endosonographic Doppler spectrum analysis is helpful in discrimination between focal chronic pancreatitis and pancreatic cancer. Pancreas 2007; 35: 286-288
    CrossrefPubMedGoogle Scholar
  • 40 Clementsen PF, Bodtger U, Konge L. et al. Diagnosis and staging of lung cancer with the use of one single echoendoscope in both the trachea and the esophagus: A practical guide. Endosc Ultrasound 2021; 10 (05) 325-334
    CrossrefPubMedGoogle Scholar
  • 41 Jenssen C, Annema JT, Clementsen P. et al. Ultrasound techniques in the evaluation of the mediastinum, part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography. J Thorac Dis 2015; 7: E439-E458
    PubMedGoogle Scholar
  • 42 Dietrich CF, Annema JT, Clementsen P. et al. Ultrasound techniques in the evaluation of the mediastinum, part I: endoscopic ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal ultrasound (TMUS), introduction into ultrasound techniques. J Thorac Dis 2015; 7: E311-E325
    CrossrefPubMedGoogle Scholar
  • 43 Dietrich CF, Mathis G, Cui XW. et al. Ultrasound of the pleurae and lungs. Ultrasound Med Biol 2015; 41: 351-365
    CrossrefPubMedGoogle Scholar