Technical procedure for ultrasound of the pleural cavity

This is an automatically translated article.

The article is expertly consulted by Master, Doctor Hoang Van Lan Duc - Doctor of Radiology - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital.

1. What is pleural ultrasound?

Pleural ultrasound is an advanced imaging technique, often used by doctors in the diagnosis and examination of the chest wall, pleura, and lung lesions adjacent to the chest wall.
Pleural ultrasound is widely used in the diagnosis of pleural effusion cases, guiding puncture, pneumothorax, pleural thickening...
1.1 Advantages of pleural ultrasound many advantages such as:
Do not use irradiation to perform, avoid certain effects of radiation. With a compact ultrasound device, doctors can directly conduct ultrasound in the hospital bed for seriously ill patients who cannot move. Low cost and quick visit time.

1.2 Disadvantages of pleural ultrasound Besides the advantages of pleural ultrasound, this method still has certain limitations such as: The resolution of the image depends on the equipment performed, the ultrasound image is not objective, sometimes it depends on the performer. Doctors often have difficulty in diagnosing ultrasound images, needing to combine with x-rays to get a more accurate diagnosis.

2. In what cases does the doctor order a pleural ultrasound?

In the following cases, the doctor will appoint the patient to perform an ultrasound of the pleural cavity:
Help the doctor examine the pleural effusion if there is effusion or is suspected. Clarifying the nature of the opacities of the chest wall or pleura due to tumor or fluid. Helps to differentiate pleural effusion from localized subdiaphragmatic fluid, assess diaphragm mobility. Check the thickness of the pleura, tumors on the pleura, or invasion of the chest wall. Ultrasound of the pleural cavity supports monitoring or early detection of complications caused by pleural effusion

3. Technical procedure of pleural cavity ultrasound

Procedure for performing pleural ultrasound technique takes place as follows:
The patient does not need to prepare anything before performing the ultrasound. A change of hospital gown is possible if required. The patient is scanned in two positions lying down and sitting, depending on the doctor's request. In the lying position, the doctor can easily check the pleura at the lateral and posterior costal angles, the basal lung parenchyma, and assess the diaphragm and pleura through the liver. When performing the sitting position, it will help the doctor examine the diseases in the chest wall, pleura, look for pleural effusion in a small amount. Prepare an ultrasonic transducer with two curved probes with a frequency of 3.5-5 MHz, a flat probe with a frequency of 5-10 MHz. The doctor will apply a layer of gel on top of the transducer with the aim of making the ultrasound image clearer. The doctor will move the transducer along the intercostal position from the top of the lung to the dome of the diaphragm, compare it with the opposite side and change the respiratory rhythms if there is any damage. When the transducer moves to the position between the parietal pleura and visceral pleura, if there is a negative space, this is a sign of pleural effusion. The doctor will use a probe with a frequency of 3.5 MHz to determine the relative extent of the effusion. For the case of pneumothorax, the ultrasound image will not show the sliding lung image, the comet tail image and the pleural line will be enlarged. Master. Doctor Hoang Van Lan Duc was formally trained and graduated with a Master's degree from Hanoi Medical University. The doctor has more than 10 years of experience in the field of imaging, especially in diagnosing with emergency internal, surgical, abdominal, thoracic, musculoskeletal, neurological and thyroid, breast, ...
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