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Vol. 60. Issue 1.
Pages 33-43 (January 2024)
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Vol. 60. Issue 1.
Pages 33-43 (January 2024)
Review Article
Ultrasound in the Study of Thoracic Diseases: Innovative Aspects
Beatriz Romero Romeroa,
Corresponding author

Corresponding author.
, Iván Vollmer Torrubianob, Jose Martín Juana, Sarah Heili Fradesc, Javier Pérez Pallaresd, Virginia Pajares Ruize, Aurelio Wangüemert Pérezf, Hernández Cristina Ramosg, Enrique Cases Viedmah
a Unidad Médico Quirúrgica Enfermedades Respirartorias, Hospital Vírgen del Rocío de Sevilla, Sevilla, Spain
b Unidad de Radiología, Hospital Clinic Barcelona, Barcelona, Spain
c Servicio de Neumología, Unidad de Cuidados Intermedios Respiratorios, Hospital Fundación Jiménez Díaz, Madrid, Spain
d Servicio de Neumología, Hospital de Santa Lucía, Cartagena, Spain
e Servicio de Neumología, Hospital Santa Creu i Sant Pau, Barcelona, Spain
f Servicio de Neumología, Hospital San Juan de Dios, Tenerife, Spain
g Servicio de Neumologia, Hospital Alvaro Cunqueiro, Vigo, Spain
h Servicio de Neumologia, Hospital La Fe, Valencia, Spain
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Table 1. Typical Findings on Contrast-enhanced Lung Ultrasound that Allow Differentiation Between Benignity and Malignancy.
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Thoracic ultrasound (TU) has rapidly gained popularity over the past 10 years. This is in part because ultrasound equipment is available in many settings, more training programmes are educating trainees in this technique, and ultrasound can be done rapidly without exposure to radiation.

The aim of this review is to present the most interesting and innovative aspects of the use of TU in the study of thoracic diseases.

In pleural diseases, TU has been a real revolution. It helps to differentiate between different types of pleural effusions, guides the performance of pleural biopsies when necessary and is more cost-effective under these conditions, and assists in the decision to remove thoracic drainage after talc pleurodesis.

With the advent of COVID19, the use of TU has increased for the study of lung involvement. Nowadays it helps in the diagnosis of pneumonias, tumours and interstitial diseases, and its use is becoming more and more widespread in the Pneumology ward.

In recent years, TU guided biopsies have been shown to be highly cost-effective, with other advantages such as the absence of radiation and the possibility of being performed at bedside. The use of contrast in ultrasound to increase the cost-effectiveness of these biopsies is very promising.

In the study of the mediastinum and peripheral pulmonary nodules, the introduction of echobronchoscopy has brought about a radical change. It is a fully established technique in the study of lung cancer patients. The introduction of elastography may help to further improve its cost-effectiveness.

In critically-ill patients, diaphragmatic ultrasound helps in the assessment of withdrawal of mechanical ventilation, and is now an indispensable tool in the management of these patients. In neuromuscular patients, ultrasound is a good predictor of impaired lung function. Currently, in Neuromuscular Disease Units, TU is an indispensable tool. Ultrasound study of the intercostal musculature is also effective in the study of respiratory function, and is widely used in Respiratory Rehabilitation.

In Intermediate Care Units, thoracic ultrasound is indispensable for patient management. In these units there are ultrasound protocols for the management of patients with acute dyspnoea that have proven to be very effective.

Pleural biopsies
Lung biopsies


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