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Pleural Ultrasound for Clinicians


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Table of Contents

Clinical Indications for Pleural Ultrasound
Advantages of Pleural Ultrasound over Clinical Assessment and Chest Radiography
Pleural Ultrasonography by Chest Physicians
Diagnostic Applications of Pleural Ultrasound
Ultrasonography in Pleural Procedures

Basic Physics of Diagnostic Ultrasound and Control "Knobology"
Generation and Transmission of the Ultrasound Wave
Interaction of Sound Waves with Matter
Formation of the Ultrasound Image
Characteristics of the Ultrasound Beam
Ultrasound controls-"Knobology"
Doppler imaging

Getting Started: Bringing the Ultrasound Machine to the Patient
Bedside Ultrasound: Introduction
Performing the scan
Recording Results: Archiving Ultrasound Images
Guiding Intervention

Image Interpretation: Normal Ultrasound of the Chest
The Diaphragm and Upper Abdominal Organs
The Pleura
Chest Wall and Ribs
Common Artifacts and Signs Seen in the Normal Lung

Image Interpretation: Pleural Effusions
Pleural Effusion-Basic Appearance
Evidence for Thoracic Ultrasound in Pleural Fluid Detection
Calculation of Pleural Fluid Volume
Differentiation of Fluid Characteristics
Further Diagnostics

Image Interpretation: Related Thoracic Structures
Chest wall
Chest Tubes and Indwelling Pleural Catheters

Ultrasonographic Features of a Pneumothorax
Common Ultrasonographic Mimics of a Pneumothorax

Artifacts, Pitfalls, and Limitations
Common Artifacts in Pleural Ultrasound
Common Problems in User Interpretation of the Pleural Space

Real-Time Ultrasound-Guided Pleural Procedures
Proper Positioning for Pleural Procedures
Erect Positioning
Supine Positioning
Lateral and Semidecubitus Positioning
Pleural Access Site Identification
Pleural Access for Diagnostic and Therapeutic Aspiration
Pleural Access for Intercostal Tube Drainage
Real-Time Ultrasound-Guided Pleural Procedures
Other Uses for Ultrasound-Guided Pleural Access

Ultrasound Skills and Application beyond the Pleura
Extrathoracic Lymph Nodes
Chest Wall and Skeletal Pathology
Pulmonary Pathology
Mediastinal Pathology

Ultrasound Training and Accreditation
Teaching Methods
The Future of Ultrasound Training
Specific Training Requirements around the World
Continuous Professional Development

Choosing A Thoracic Ultrasound Machine
Technical Factors
Cost Factors

About the Author

Claire L Tobin BA BMBCh MRCP, Clinical Pleural Fellow, Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia. Y C Gary Lee MBChB PhD FCCP FRACP Winthrop Professor of Respiratory Medicine, University of Western Australia; Consultant & Director of Pleural Services, Respiratory Department, Sir Charles Gairdner Hospital; Head, Pleural Disease Unit, Lung Institute of Western Australia.


"This is the first book on this topic and it is a valuable contribution to the field of pulmonology. I teach and perform ultrasound-guided pleural procedures, and I found this to be a complete and concise manual on the topic. Weighted numerical score: 99 - 5 stars."
-K. P. Ravikrishnan, FRCP(C), FACP (William Beaumont Hospitals), from Doody's Book Reviews (TM)

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