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Ultrasonography Pleural Effusion Part 4 -Dr. Sheetu Singh

Ultrasonography Pleural Effusion Part 4 -Dr. Sheetu Singh Visit www.drsheetusingh.com

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Ultrasonography Pleural Effusion Part 4 -Dr. Sheetu Singh

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  1. Radiology – Chest X ray Lateral decubitus film • Free pleural fluid is evidenced by a homogenous density with a straight horizontal superior border between the dependent chest wall and the lower border of the lung • This appearance is due to the lung floating in the fluid. • Minimum amount of pleural fluid to be visualized on lateral decubitus x ray – 25 ml

  2. Chest X ray – Lateral decubitus view

  3. Ultrasonography (a)determining whether pleural fluid is present (b) identification of the appropriate location for an attempted thoracentesis, pleural biopsy, or chest tube placement (c) identification of pleural fluid loculations (d) distinction of pleural fluid from pleural thickening (e) semiquantitation of the amount of pleural fluid (f) differentiation of a pyopneumothorax from a lung abscess (g) evaluation of the trauma patient for the presence of a hemothorax or a pneumothorax. (h) Special utility in ICU where supine films can miss pleural effusion in many cases

  4. Computed Tomography (CT) • Helps identify underlying parenchymal abnormalities • Differentiate transudative from exudative pleural effusion • Differentiate malignant pleural effusion by – presence of pleural nodularity, pleural rind, pleural thickening > 1 cm and mediastinal pleural involvement

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