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Transthoracic US Transthoracic US (TTUS) of the Chest(TTUS) of the Chest
Clinical ApplicationsClinical Applications
ByBy
Hussein Attia MDHussein Attia MD
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USES: USES:
Evaluation of
1 -Peripheral parenchymal
2 -Pleural
3 -chest wall disease
4 -Interventional procedures of the chest wall and
pleural space
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Parenchymal DiseasesParenchymal Diseases
Pneumonia Pneumonia NeoplasmsNeoplasms Heart failureHeart failure InfarctInfarct Round atelectasis Round atelectasis
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Pleural DiseasesPleural Diseases
Pleural effusionPleural effusion PneumothoraxPneumothorax Pleural massPleural mass MesotheliomaMesothelioma
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Chest wall abnormalitiesChest wall abnormalities
Chest wall tumorsChest wall tumors Rib fractures Rib fractures
Other applicationsOther applications
Diaphragmatic paralysis Diaphragmatic paralysis
US Guided biopsy US Guided biopsy
Thoracocentesis Thoracocentesis
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Technique an Technique an instrumentations instrumentations US 2-5 MHz curvilinear probeUS 2-5 MHz curvilinear probe High resolution 7.5-10 MHzHigh resolution 7.5-10 MHz Gray scale and Color Doppler Gray scale and Color Doppler
imaging imaging Patient position Patient position
a)a) Raised arm position (in recumbence) Raised arm position (in recumbence)
b)b) Posterior chest in sitting, or lateral Posterior chest in sitting, or lateral standing positionstanding position
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Sitting
Lateral debcubitus
Supine suprasternal
approach
Scanning positioning Scanning positioning
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Normal anatomyNormal anatomy
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Diseases of the Pleural Diseases of the Pleural spacespace
Anechoic effusion
Complex septated pleural
effusion
Empyema
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Diseases of the Pleural space Diseases of the Pleural space
Pleural thickening
CT mesothelioma
US mesothelioma
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Diseases of the Lung Diseases of the Lung ParenchymaParenchyma Pneumonia and lung abscess Pneumonia and lung abscess
US consolidation collapse of right lung lower lobe
CD scan showing pulmonary artery branch supplying the collapsed segment
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Central perihilar masses Central perihilar masses
CT central neoplasm US central neoplasm demonstrating both mass and lung consolidation
MC
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Neoplasm (Pancoast tumor)Neoplasm (Pancoast tumor)
US transapical viewPlain X ray AP view
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Round atelectasis Round atelectasis
US: pleural invagination sign
CT: round atelactasis within the left lung base
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Diseases of the chest wall Diseases of the chest wall (lipoma)(lipoma)
MRI: T1W Coronal
US: 10 MHz
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Diseases of the chest wall Diseases of the chest wall (Hemangioma)(Hemangioma)
MRI: T2W Axial image
US linear scan
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Diseases of the chest wall (lymph Diseases of the chest wall (lymph nodes)nodes)
US: Hyperplastic lymph node
CD: Hyperplastic lymph node
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Metastatic lymph nodes Metastatic lymph nodes
US: metastatic lymph node
PD: metastatic lymph node
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Chest wall (rib fracture)Chest wall (rib fracture)
US linear scan
rib
H
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Mediastinal Intervention Mediastinal Intervention
Biopsy of mediastinal massesBiopsy of mediastinal masses
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Pleural effusion and basal Pleural effusion and basal collapsecollapse
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Normal CPA comet-tail Normal CPA comet-tail artifactartifact
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THANK YOU