ISSN 2398-2942      

Ultrasonography: thorax (non-cardiac)

icanis

Introduction

Uses

Advantages

  • Low cost.
  • Non-invasive.
  • Short time requirement if experienced.
  • Examination possible without sedation.
  • No known biological risk
  • Allows ultrasound guided: Fine needle aspirate (FNA) Fine needle aspirate: ultrasound-guided or large-bore biopsy procedures (tru-cut biopsy) Biopsy: ultrasound-guided.
  • Allows evaluation of other organs for related problems, eg abdominal organs in diaphragmatic hernia Diaphragm: traumatic hernia or if neoplastic disease suspected.

Disadvantages

  • Investigation is dependent on operator skill and suitability of ultrasonographic equipment.
  • Examination is poorly reproducible and remote interpretation difficult.
  • May require patients coat to be clipped.
  • Normal sonographic appearance does not exclude disease.
  • Ultrasound investigation doesnt replace thoracic radiography, it complements it.
  • Abnormal sonographic appearance doesnt always indicate significant disease.
  • Similar sonographic appearance with different diseases.

Potential problems

  • Poor transducer-skin contact (inadequate clipping or insufficient coupling gel).
  • Inadequate patient restraint.
  • Operator inexperience.
  • Lesion obscured by aerated lung.
  • Acoustic shadowing artifacts produced by the ribs.
  • Inadequate equipment (transducers with large contact area).

Alternatives

  • Plain or contrast radiography Radiography: thorax will complement the ultrasonographic investigation.
  • CT Computed tomography is the imaging modality of choice for evaluating the thoracic structures including the lungs because of its superior contrast resolution and tomographic nature.
  • MRI Magnetic resonance imaging: basic principles has proven extremely valuable to evaluate abnormalities of the thoracic wall, diaphragm, and mediastinum. MRI can also be valuable for both anatomic and functional assessment of the great vessels and pulmonary arteries. Its clinical value to assess lung disease is currently limited.

Equipment

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Patient preparation

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Normal anatomy

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Abnormalities

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Interventional procedures

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Reichle J K & Wisner E R (2000) Non-cardiac thoracic ultrasound in 75 feline and canine patients. Vet Radiol Ultrasound 41 (2), 154-162 PubMed.
  • Tidwell A S (1998) Ultrasonography of the thorax (excluding the heart). Vet Clin North Am Small Anim Pract 28 (4), 993-1015 PubMed.
  • Stowater J L & Lamb C R (1989) Ultrasonography of noncardiac thoracic diseases in small animals. JAVMA 195 (4), 514-520 PubMed.

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