2009 Thoracic Ultrasound

Submitted by Dr LAU Chun Wing Arthur in 2009

Department of Intensive Care, PYNEH, Hong Kong


Ultrasound thorax in general

Ultrasound thorax in general (both low freq and high freq USG): Daniel A. Lichtenstein, MD. Ultrasound in the management of thoracic disease. Crit Care Med 2007; 35[Suppl.]:S250–S261

Low frequency

Use the probe frequency as that for USG abdomen

To look for pleural effusinon +/- guidance for r chest tapping

Septated pleural effusion: http://hk.youtube.com/watch?v=n3uLhUjjUnU


High frequency

The USG we are using is Sonosite Titan.




Dyspnea assessment


The comet tail artefact: DANIEL LICHTENSTEIN, GILBERT MÉZIÈRE, PHILIPPE BIDERMAN, AGNÈS GEPNER, and OLIVIER BARRÉ. The Comet-tail Artifact: An Ultrasound Sign of Alveolar-Interstitial Syndrome. AM J RESPIR CRIT CARE MED 1997;156:1640–1646.


Occult pneumothorax diagnosis: Daniel A. Lichtenstein, MD; Gilbert Mezière, MD; Nathalie Lascols, MD; Philippe Biderman, MD; Jean-Paul Courret, MD; Agnès Gepner, MD; Ivan Goldstein, MD; Marc Tenoudji-Cohen, MD. Ultrasound diagnosis of occult pneumothorax. Crit Care Med 2005; 33:1231–1238


Pneumothorax: DA Lichtenstein and Y Menu. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest 1995;108;1345-1348

Alveolar-interstitial syndrome: Giovanni Volpicellia,*, Alessandro Mussaa, Giorgio Garofalob, Luciano Cardinaleb, Giovanna Casolia, Fabio Perottob, Cesare Favab, Mauro Frasciscoa. Bedside lung ultrasound in the assessment of alveolar-interstitial syndrome. American Journal of Emergency Medicine (2006) 24, 689–696

Diaphragm Movement And Contractility Evaluation By Thoracic Ultrasound (also see the Original Research article the slides refer to: Nicolas Lerolle, Emmanuel Guérot, Saoussen Dimassi, Rachid Zegdi, Christophe Faisy, Jean-Yves Fagon, and Jean-Luc Diehl. Ultrasonographic Diagnostic Criterion for Severe Diaphragmatic Dysfunction After Cardiac Surgery. Chest February 2009 135:401-407; published ahead of print August 27, 2008, doi:10.1378/chest.08-1531
Thoracic ultrasound for the Respiratory System in Critically Ill Patients
Thoracic ultrasound for diagnosing pulmonary embolism