Journal of clinical ultrasound : JCU
-
We prospectively examined 26 patients who were referred for ultrasound-guided thoracentesis, following at least one unsuccessful, clinically guided attempt. Sonographically guided thoracentesis was successful in obtaining fluid in 88% of patients. ⋯ Patients who have undergone an unsuccessful clinically guided thoracentesis and are referred for sonographic assistance represent a selected group who may have complicating factors not typically present during routine thoracentesis. Awareness of these potential complicating factors may facilitate the performance of ultrasound-guided thoracenteses.
-
Doppler ultrasonography was used to examine 198 neck-vein systems (67 right, 131 left) in 148 patients. The vessel lumen is usually echo-free: the veins are supple, and the internal jugular and sometimes the subclavian veins can be compressed. The venous confluence is Y-shaped. ⋯ Blood flow velocity was less than 1 m/s in all cases and varied with respiration and heart rate. Color Doppler allows flow imaging and increases the speed and reliability of the procedure. This investigation is useful for following-up patients with indwelling venous catheters and is the investigation of choice whenever pathology of the neck veins is suspected.
-
All children in the Oncology Unit in the Royal Hospital for Sick Children, Edinburgh who had had long-term central venous catheters removed between 1987 and 1991 underwent central venous assessment by image-directed Doppler ultrasound scanning techniques. In this study, the implant vein remained patent after decannulation, and we believe should be re-accessed rather than moving to another site.
-
Vascular signals arising from pleura-based lung lesions were studied in 50 patients using pulsed Doppler ultrasonography. Twenty-seven had malignant lesions and 23 benign lesions. In 24/27 of the malignant masses, we observed no Doppler signals: in 2 cases, a low-velocity, turbulent, pulsatile flow was demonstrated; in 1 case pulsed Doppler ultrasonography showed only a low-velocity, continuous flow. ⋯ The last 8 patients of our series underwent color Doppler ultrasound examination, which demonstrated the presence of arterial and venous vessels in 4 benign lesions and the absence of blood flow in 4 malignant masses. To our knowledge, we report for the first time the ability of obtaining Doppler signals from a variety of lung lesions. The actual clinical relevance of this application requires further studies.
-
Ultrasonography is considered to have limited application in respiratory diseases because air reflects sound waves. Twenty-four patients with radiologically confirmed pneumothorax and 100 healthy subjects underwent sonography. In all normal subjects, the hyperechoic pulmonary interface showed respiratory motions termed the "gliding sign" with some comet-tail artifacts. ⋯ The extent of collapse cannot be evaluated, but it is possible to determine its area in partial pneumothorax (N = 5). The follow-up (N = 8) showed the reappearance of the gliding sign. Ultrasonography may be helpful in diagnosing pneumothorax in certain cases.