Chapter 19 - Ultrasound Evaluation of the Lung
Video 19-1. The rib pleural line, the rib shadows, and A lines and lung sliding are present. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the second intercostal space in the mid-clavicular line.
Video 19-2. Lung sliding is present. The image is obtained using a 7.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the second intercostal space in the mid-clavicular line. The higher frequency 7.5 MHz probe results in better resolution of the pleural interface, compared to that obtained with the 3.5 MHz probe, although with less depth of penetration.
Video 19-3. Lung pulse is present. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the second intercostal space in the mid-clavicular line.
Video 19-4. There is absent lung sliding. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the second intercostal space in the mid-clavicular line.
Video 19-5. There is absent lung sliding. The image is obtained using a 7.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the second intercostal space in the mid-clavicular line.
Video 19-6. A lung point is present. The partially deflated lung moves into the pneumothorax space in respirophasic pattern. Identification of a lung point is diagnostic for a pneumothorax. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 6th intercostal space in the anterior axillary line.
Video 19-7. A lung point is present. The partially deflated lung is seen to move underneath a rib into the pneumothorax space in respirophasic pattern. Identification of a lung point is diagnostic for a pneumothorax. The image is obtained using a 7.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 5th intercostal space in the anterior axillary line.
Video 19-8. A single B line is present. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 8th intercostal space in the mid-axillary line. A few B lines are commonly encountered in this region as a normal finding.
Video 19-9. Profuse B lines are present to the extent that individual B lines cannot be identified. The image is obtained using a 3.5 MHz transducer. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 3rd intercostal space in the mid-clavicular line.
Video 19-10. There is alveolar consolidation of the left lower lobe. The diaphragm and descending aorta are identified. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 6th interspace in the mid-axillary line.
Video 19-11. There is alveolar consolidation of the right lower lobe. During inspiration, the aerated lung moves into the scanning plane and blocks visualization of the consolidated lung (curtain sign). There is a small pleural effusion. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 6th intercostal space in the mid-axillary line.
Video 19-12. There is alveolar consolidation of the right lower lobe with mobile air bronchograms represented by punctate hyperechoic foci within the consolidated lung that move in respirophasic manner. These represent intrabronchial air, and their mobility indicates that the bronchus supplying area is patent. The transducer is in longitudinal orientation and placed perpendicular to the chest wall to scan through the 6th intercostal space in the mid-axillary line. The gain is reduced in order to better visualize the air collections.