Equis ISSN 2398-2977

Ultrasonography: thorax

Contributor(s): Chris Whitton

Introduction

  • Ultrasound is a useful diagnostic tool for thoracic conditions causing effusions and peripheral lung changes   Ultrasonography: overview  .
  • Structures normally containing air will cause complete reflection of the beam.
  • Characteristic artefacts are caused by the sound waves reverberating between the highly reflective surface and the transducer.
  • Alterations in degree of aeration and position of aerated tissue results in changes in the ultrasonographic appearance of thoracic structures.

Uses

  • Diagnosis of abnormal auscultatory findings not involving airways   Thorax: auscultation  .
  • Diagnosis of pleural and pulmonary disease involving lung periphery.
  • Characterization of pleural effusion and severity of pulmonary disease in pleuropneumonia   Lung: pneumonia - neonatal bacterial    →   prognostication.
  • Monitoring treatment and recovery from pleural and pulmonic conditions.
  • Guide percutaneous drainage of pleural effusion, superficial pulmonary abscesses   Lung: abscess  .
  • Assist localization of lesions with thoracoscopy   Thorax: thoracoscopy  .

Advantages

  • Two planes of view can be obtained.
  • Simple, quick, non-invasive and safe to personnel.
  • Portable, cheap.

Disadvantages

  • Access to lung fields limited to intercostal space.
  • Depth of visualization limited, depending on degree of pathology.
  • Not useful for diagnosing interstitial changes, deep parenchymatous lesions and small diaphragmatic hernias.
  • Cannot characterize the nature of diaphragmatic hernia.
  • Less valuable than radiography for diagnosis of edema and pneumothorax.
  • Structures not normally visualized ultrasonographically:
    • Right accessory lung lobe.
    • Cranial vena cava and associated vessels, esophagus and trachea.
    • Caudal vena cava (unless pleural fluid displaces lung dorsally or significant lung consolidation is present).

Requirements

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Preparation

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Procedure

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Cortez J, Aguilar J J, Lagioia M, Fernandez R & Losinno L (2008) Use of ultrasonography to detect pulmonary lesions in Thoroughbred foals in Argentina. Equine Vet Educ 20 (3), 154-158 VetMedResource.
  • Menzies-Gow N (2008) Equine thoracic ultrasonography. UK Vet 13 (5), 19-25 VetMedResource.
  • Donaldson M T et al (1998) Interstitial pneumonia and pulmonary fibrosis in a horse. Equine Vet J 30 (2), 173-175 PubMed.
  • Garber J L et al (1994) Sonographic findings in horses with mediastinal lymphosarcoma - 13 cases (1985-1992). JAVMA 205 (10), 1432-1436 PubMed.
  • Reef V B et al (1991) Comparison between diagnostic ultrasonography and radiography in the evaluation of horses and cattle with thoracic disease - 56 cases (1984-1985). JAVMA 198 (12), 2112-2118 PubMed.
  • Reimer J M et al (1989) Ultrasonography as a diagnostic aid in horses with anaerobic bacterial pleuropneumonia and/or pulmonary abscessation - 27 cases (1984-1986). JAVMA 194 (2) 278-282 PubMed.
  • Rantanen N W (1986) Diseases of the thorax. Vet Clin North Am Equine Pract (1), 49-66 PubMed.

Other sources of information

  • Rantanen N W (1998)Thoracic Ultrasound.In:Equine Diagnostic Ultrasonography.Ed: Rantanen N W & McKinnon A O. Williams & Wilkins, Baltimore. ISBN 0-683-07123-8.
  • Rantanen N W (1998)Evaluation of the Respiratory System.In:Equine Diagnostic Ultrasonography.Ed: Rantanen N W & McKinnon A O. Williams &Wilkins, Baltimore. ISBN 0-683-07123-8.


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