Role of thoracic ultrasound in diagnosis of pulmonary and pleural diseases in critically ill patients Introduction: Traditionally, lung imaging in critically ill patients is usually performed either by bedside chest radiography (CXR) or thoracic computed tomography (CT), but both techniques have limitations which constrain their usefulness. Although thoracic CT is the gold standard for lung imaging, it is expensive and cannot be performed on a routine basis as the transportation of critically ill patients to the radiology department combined with the radiation exposure carries a measurable risk (1,2). On the other hand, limitations of bedside CXR have been well described and lead to poor quality X-ray films with low sensitivity (3). It has …show more content…
CT scans were evaluated for mediastinal and pleural pathology and lung lesions as described by the Nomenclature Committee of the Fleischner Society (11). Lung regions were located using the same anatomical landmarks as with X-ray. The evaluation of CT was performed by a radiologist unaware of the lung ultrasound and CXR findings. Thoracic ultrasound: Visualization of the lungs was performed using a micro convex 5–9 MHz transducer appropriate for transthoracic examination. Access to standardized images (seashore sign, stratosphere sign) was possible. Ultrasonography was evaluated by a single operator, who was unaware of the CT and CXR findings. Lungs were divided into 12 regions. The anterior surface of each lung was defined by clavicle, parasternal, anterior axillary line, and diaphragm and was divided into two areas, upper and lower. The lateral surface was defined by the anterior and posterior axillary lines and divided into upper and lower areas. Finally, the posterior lung surface was defined by the posterior axillary and the paravertebral lines and divided into an upper and lower areas. The apex was scanned from the supraclavicular space