Thoracic ultrasound: An adjunctive and valuable imaging tool in emergency, resource-limited settings and for a sustainable monitoring of patients

Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato, Francesca M Trovato, Daniela Catalano, Guglielmo M Trovato

Abstract

Imaging workup of patients referred for elective assessment of chest disease requires an articulated approach: Imaging is asked for achieving timely diagnosis. The concurrent or subsequent use of thoracic ultrasound (TUS) with conventional (chest X-rays-) and more advanced imaging procedures (computed tomography and magnetic resonance imaging) implies advantages, limitations and actual problems. Indeed, despite TUS may provide useful imaging of pleura, lung and heart disease, emergency scenarios are currently the most warranted field of application of TUS: Pleural effusion, pneumothorax, lung consolidation. This stems from its role in limited resources subsets; actually, ultrasound is an excellent risk reducing tool, which acts by: (1) increasing diagnostic certainty; (2) shortening time to definitive therapy; and (3) decreasing problems from blind procedures that carry an inherent level of complications. In addition, paediatric and newborn disease are particularly suitable for TUS investigation, aimed at the detection of congenital or acquired chest disease avoiding, limiting or postponing radiological exposure. TUS improves the effectiveness of elective medical practice, in resource-limited settings, in small point of care facilities and particularly in poorer countries. Quality and information provided by the procedure are increased avoiding whenever possible artefacts that can prevent or mislead the achievement of the correct diagnosis. Reliable monitoring of patients is possible, taking into consideration that appropriate expertise, knowledge, skills, training, and even adequate equipment's suitability are not always and everywhere affordable or accessible. TUS is complementary imaging procedure for the radiologist and an excellent basic diagnostic tool suitable to be shared with pneumologists, cardiologists and emergency physicians.

Keywords: Clinical risk management; Overdiagnosis; Pleural effusion; Pneumonia; Pneumothorax; Thoracic ultrasound; Wastebasket diagnosis.

Conflict of interest statement

Conflict-of-interest statement: No conflict of interest is declared in this invited manuscript.

References

    1. Blair JS. Marie Curie’s other role. J R Army Med Corps. 2005;151:117–118.
    1. Joyner CR, Miller LD, Dudrick SJ, Eskin DJ, Bloom P. Reflected ultrasound in the study of diseases of the chest. Trans Am Clin Climatol Assoc. 1967;78:28–37.
    1. Rosenberg HK. The complementary roles of ultrasound and plain film radiography in differentiating pediatric chest abnormalities. Radiographics. 1986;6:427–445.
    1. Alessi V, Bianco S, Bianco BP, Capizzi C, Ganci G, Marotta R, Traina G. The diagnostic potentials of echography in thoracic pathology. Radiol Med. 1990;79:438–452.
    1. Sartori S, Tombesi P. Emerging roles for transthoracic ultrasonography in pleuropulmonary pathology. World J Radiol. 2010;2:83–90.
    1. Sartori S, Tombesi P. Emerging roles for transthoracic ultrasonography in pulmonary diseases. World J Radiol. 2010;2:203–214.
    1. Sartori S, Postorivo S, Vece FD, Ermili F, Tassinari D, Tombesi P. Contrast-enhanced ultrasonography in peripheral lung consolidations: What’s its actual role? World J Radiol. 2013;5:372–380.
    1. May DA, Barth RA, Yeager S, Nussbaum-Blask A, Bulas DI. Perinatal and postnatal chest sonography. Radiol Clin North Am. 1993;31:499–516.
    1. Giron J, Sans N, Fajadet P, Baunin C, Sénac JP. [Thoracic ultrasound] Rev Pneumol Clin. 2000;56:103–113.
    1. Chavez MA, Naithani N, Gilman RH, Tielsch JM, Khatry S, Ellington LE, Miranda JJ, Gurung G, Rodriguez S, Checkley W. Agreement Between the World Health Organization Algorithm and Lung Consolidation Identified Using Point-of-Care Ultrasound for the Diagnosis of Childhood Pneumonia by General Practitioners. Lung. 2015;193:531–538.
    1. Beckh S, Bölcskei PL, Lessnau KD. Real-time chest ultrasonography: a comprehensive review for the pulmonologist. Chest. 2002;122:1759–1773.
    1. Dietrich CF, Hirche TO, Schreiber D, Wagner TO. Sonographie von pleura und lunge. Ultraschall Med. 2003;24:303–311.
    1. Diacon AH, Theron J, Bolliger CT. Transthoracic ultrasound for the pulmonologist. Curr Opin Pulm Med. 2005;11:307–312.
    1. Sperandeo M, Rotondo A, Guglielmi G, Catalano D, Feragalli B, Trovato GM. Transthoracic ultrasound in the assessment of pleural and pulmonary diseases: use and limitations. Radiol Med. 2014;119:729–740.
    1. American College of Emergency Physicians. Emergency ultrasound guidelines. Ann Emerg Med. 2009;53:550–570.
    1. Freeman HJ. Refractory celiac disease and sprue-like intestinal disease. World J Gastroenterol. 2008;14:828–830.
    1. Hu QJ, Shen YC, Jia LQ, Guo SJ, Long HY, Pang CS, Yang T, Wen FQ. Diagnostic performance of lung ultrasound in the diagnosis of pneumonia: a bivariate meta-analysis. Int J Clin Exp Med. 2014;7:115–121.
    1. Sperandeo M, Trovato FM, Dimitri L, Catalano D, Simeone A, Martines GF, Piscitelli AP, Trovato GM. Lung transthoracic ultrasound elastography imaging and guided biopsies of subpleural cancer: a preliminary report. Acta Radiol. 2015;56:798–805.
    1. The European Society of Radiology. Risk management in Radiology in Europe [updated 2004 Nov] Available from: .
    1. Craciun H, Mankad K, Lynch J. Risk management in radiology departments. World J Radiol. 2015;7:134–138.
    1. Otero HJ, Rybicki FJ, Greenberg D, Neumann PJ. Twenty years of cost-effectiveness analysis in medical imaging: are we improving? Radiology. 2008;249:917–925.
    1. Otero HJ, Rybicki FJ, Greenberg D, Mitsouras D, Mendoza JA, Neumann PJ. Cost-effective diagnostic cardiovascular imaging: when does it provide good value for the money? Int J Cardiovasc Imaging. 2010;26:605–612.
    1. Fang C, Otero HJ, Greenberg D, Neumann PJ. Cost-utility analyses of diagnostic laboratory tests: a systematic review. Value Health. 2011;14:1010–1018.
    1. Otero HJ, Fang CH, Sekar M, Ward RJ, Neumann PJ. Accuracy, risk and the intrinsic value of diagnostic imaging: a review of the cost-utility literature. Acad Radiol. 2012;19:599–606.
    1. Cannavale A, Santoni M, Passariello R, Arbarello P. Risk management in radiology. Radiol Manage. 2013;35:14–19; quiz 20-21.
    1. Wüstner A, Gehmacher O, Hämmerle S, Schenkenbach C, Häfele H, Mathis G. Ultrasound diagnosis in blunt thoracic trauma. Ultraschall Med. 2005;26:285–290.
    1. Trovato GM. Sustainable medical research by effective and comprehensive medical skills: overcoming the frontiers by predictive, preventive and personalized medicine. EPMA J. 2014;5:14.
    1. Golubnitschaja O, Costigliola V. EPMA summit 2014 under the auspices of the presidency of Italy in the EU: professional statements. EPMA J. 2015;6:4.
    1. Lemke HU, Golubnitschaja O. Towards personal health care with model-guided medicine: long-term PPPM-related strategies and realisation opportunities within ‘Horizon 2020’. EPMA J. 2014;5:8.
    1. Sartori S, Tombesi P, Trevisani L, Nielsen I, Tassinari D, Abbasciano V. Accuracy of transthoracic sonography in detection of pneumothorax after sonographically guided lung biopsy: prospective comparison with chest radiography. AJR Am J Roentgenol. 2007;188:37–41.
    1. Wernecke K, Galanski M, Peters PE, Hansen J. Pneumothorax: evaluation by ultrasound--preliminary results. J Thorac Imaging. 1987;2:76–78.
    1. Targhetta R, Bourgeois JM, Balmes P. Echography of pneumothorax. Rev Mal Respir. 1990;7:575–579.
    1. Press GM, Miller SK, Hassan IA, Alade KH, Camp E, Junco DD, Holcomb JB. Prospective evaluation of prehospital trauma ultrasound during aeromedical transport. J Emerg Med. 2014;47:638–645.
    1. Trovato G, Sperandeo M. A picture is worth a thousand words: the need for CT for assessment of size and distribution of pneumothorax. Intensive Care Med. 2014;40:1614–1615.
    1. Trovato G, Sperandeo M. Lung Ultrasound in Pneumothorax: The Continuing Need for Radiology. J Emerg Med. 2016;51:189–191.
    1. Cardinale L, Priola AM, Moretti F, Volpicelli G. Effectiveness of chest radiography, lung ultrasound and thoracic computed tomography in the diagnosis of congestive heart failure. World J Radiol. 2014;6:230–237.
    1. Trovato GM, Sperandeo M. Sounds, ultrasounds, and artifacts: which clinical role for lung imaging? Am J Respir Crit Care Med. 2013;187:780–781.
    1. Trovato GM, Rollo VC, Martines GF, Catalano D, Trovato FM, Sperandeo M. Thoracic ultrasound in the differential diagnosis of severe dyspnea: a reappraisal. Int J Cardiol. 2013;167:1081–1083.
    1. Trovato GM, Catalano D, Martines GF, Sperandeo M. Is it time to measure lung water by ultrasound? Intensive Care Med. 2013;39:1662.
    1. Trovato GM, Sperandeo M. Objectively Measuring the Ghost in the Machine: B-Lines as Uncertain Measures on Which to Base Clinical Assessment. JACC Cardiovasc Imaging. 2015;8:1470.
    1. Trovato GM, Sperandeo M. The resistible rise of B-line lung ultrasound artefacts. Respiration. 2015;89:175–176.
    1. Sperandeo M, Trovato GM, Catalano D. Quantifying B-lines on lung sonography: insufficient evidence as an objective, constructive, and educational tool. J Ultrasound Med. 2014;33:362–365.
    1. Al Deeb M, Barbic S, Featherstone R, Dankoff J, Barbic D. Point-of-care ultrasonography for the diagnosis of acute cardiogenic pulmonary edema in patients presenting with acute dyspnea: a systematic review and meta-analysis. Acad Emerg Med. 2014;21:843–852.
    1. Trovato GM, Sperandeo M, Catalano D. Ultrasound diagnosis of acute pulmonary edema: the oblivion of a great future behind us. Acad Emerg Med. 2015;22:244–245.
    1. Ciccarese F, Chiesa AM, Feletti F, Vizioli L, Pasquali M, Forti P, Zoli M, Zompatori M. The Senile Lung as a Possible Source of Pitfalls on Chest Ultrasonography and Computed Tomography. Respiration. 2015;90:56–62.
    1. Rea G, Trovato GM. A Farewell to B-Lines: Ageing and Disappearance of Ultrasound Artifacts as a Diagnostic Tool. Respiration. 2015;90:522.
    1. Katz JF, Yucel EK. Point-of-care ultrasonography. N Engl J Med. 2011;364:2075–2076; author reply 2076.
    1. Trovato GM, Catalano D, Sperandeo M. Assessment of lung ultrasound artifacts (B-lines): incremental contribution to echocardiography in heart failure? JACC Cardiovasc Imaging. 2014;7:635.
    1. Catalano D, Trovato GM, Sperandeo M. Acute heart failure diagnosis by ultrasound: new achievements and persisting limitations. Am J Emerg Med. 2014;32:384–385.
    1. Trovato GM, Sperandeo M. Pulmonary ultrasonography: staying within the lines prevents us finding something better on the other side. Chest. 2015;147:e236–e237.
    1. Trovato GM, Catalano D, Sperandeo M. M-mode: a valuable tool in cardiology, is not yet ready to use in pneumology. Respiration. 2014;88:518.
    1. Trovato GM, Catalano D, Sperandeo M. Echocardiographic and lung ultrasound characteristics in ambulatory patients with dyspnea or prior heart failure. Echocardiography. 2014;31:406–407.
    1. Katz JF, Bezreh JS, Yucel EK. Lung ultrasound in the intensive care unit: an idea that may be too good to be true. Intensive Care Med. 2015;41:379–380.
    1. Maggi M, Catalano D, Sperandeo M, Trovato G. Comprehensive clinical evidence for pulmonary embolism diagnosis and workup. Chest. 2014;145:1173–1174.
    1. Haller JO, Schneider M, Kassner EG, Friedman AP, Waldroup LD. Sonographic evaluation of the chest in infants and children. AJR Am J Roentgenol. 1980;134:1019–1027.
    1. Haran Jogeesvaran K, Owens CM. Chronic diseases of lung parenchyma in children: the role of imaging. Pediatr Radiol. 2010;40:850–858.
    1. Tomà P, Owens CM. Chest ultrasound in children: critical appraisal. Pediatr Radiol. 2013;43:1427–1434; quiz 1425-1326.
    1. Toma P. Lung ultrasound characteristics of community-acquired pneumonia. Pediatr Pulmonol. 2013;48:1041–1042.
    1. Toma P. Lung ultrasound in bronchiolitis. Eur J Pediatr. 2013;172:713.
    1. Tomà P, Rizzo F, Stagnaro N, Magnano G, Granata C. Multislice CT in congenital bronchopulmonary malformations in children. Radiol Med. 2011;116:133–151.
    1. Jones BP, Tay ET, Elikashvili I, Sanders JE, Paul AZ, Nelson BP, Spina LA, Tsung JW. Feasibility and Safety of Substituting Lung Ultrasonography for Chest Radiography When Diagnosing Pneumonia in Children: A Randomized Controlled Trial. Chest. 2016;150:131–138.
    1. Escourrou G, De Luca D. Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit. Acta Paediatr. 2016;105:e237–e239.
    1. Pereda MA, Chavez MA, Hooper-Miele CC, Gilman RH, Steinhoff MC, Ellington LE, Gross M, Price C, Tielsch JM, Checkley W. Lung ultrasound for the diagnosis of pneumonia in children: a meta-analysis. Pediatrics. 2015;135:714–722.
    1. Sperandeo M, Carnevale V, Muscarella S, Sperandeo G, Varriale A, Filabozzi P, Piattelli ML, D’Alessandro V, Copetti M, Pellegrini F, et al. Clinical application of transthoracic ultrasonography in inpatients with pneumonia. Eur J Clin Invest. 2011;41:1–7.
    1. Catalano D, Trovato G, Sperandeo M, Sacco MC. Lung ultrasound in pediatric pneumonia. The persistent need of chest X-rays. Pediatr Pulmonol. 2014;49:617–618.
    1. Mongodi S, Via G, Girard M, Rouquette I, Misset B, Braschi A, Mojoli F, Bouhemad B. Lung Ultrasound for Early Diagnosis of Ventilator-Associated Pneumonia. Chest. 2016;149:969–980.
    1. Liccardo B, Martone F, Trambaiolo P, Severino S, Cibinel GA, D’Andrea A. Incremental value of thoracic ultrasound in intensive care units: Indications, uses, and applications. World J Radiol. 2016;8:460–471.
    1. Sperandeo M, Filabozzi P, Carnevale V. Ultrasound Diagnosis of Ventilator-Associated Pneumonia: A Not-So-Easy Issue. Chest. 2016;149:1350–1351.
    1. Sperandeo M, Filabozzi P, Varriale A, Carnevale V, Piattelli ML, Sperandeo G, Brunetti E, Decuzzi M. Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases. J Ultrasound. 2008;11:39–46.
    1. Hunter L, Bélard S, Janssen S, van Hoving DJ, Heller T. Miliary tuberculosis: sonographic pattern in chest ultrasound. Infection. 2016;44:243–246.
    1. Giordani MT, Giaretta R, Scolarin C, Stefani MP, Pellizzari C, Tamarozzi F, Brunetti E. Ultrasound and infections on the Tibetan Plateau() J Ultrasound. 2012;15:83–92.
    1. Stolz LA, Muruganandan KM, Bisanzo MC, Sebikali MJ, Dreifuss BA, Hammerstedt HS, Nelson SW, Nayabale I, Adhikari S, Shah SP. Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department. Trop Med Int Health. 2015;20:1067–1072.
    1. Ramos-Rincón JM, Cuadros-González J, Malmierca-Corral E, de Górgolas-Hernández M. Medical diagnosis in resource-poor tropical countries. Rev Clin Esp. 2015;215:43–49.
    1. Heuvelings CC, Bélard S, Janssen S, Wallrauch C, Grobusch MP, Brunetti E, Giordani MT, Heller T. Chest ultrasonography in patients with HIV: a case series and review of the literature. Infection. 2016;44:1–10.
    1. Bélard S, Tamarozzi F, Bustinduy AL, Wallrauch C, Grobusch MP, Kuhn W, Brunetti E, Joekes E, Heller T. Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases--A Review of Applications and Perspectives. Am J Trop Med Hyg. 2016;94:8–21.
    1. Brunetti E, Heller T, Richter J, Kaminstein D, Youkee D, Giordani MT, Goblirsch S, Tamarozzi F. Application of Ultrasonography in the Diagnosis of Infectious Diseases in Resource-Limited Settings. Curr Infect Dis Rep. 2016;18:6.
    1. Heller T, Wallrauch C, Brunetti E, Giordani MT. Changes of FASH ultrasound findings in TB-HIV patients during anti-tuberculosis treatment. Int J Tuberc Lung Dis. 2014;18:837–839.
    1. Janssen S, Basso F, Giordani MT, Brunetti E, Grobusch MP, Heller T. Sonographic findings in the diagnosis of HIV-associated tuberculosis: image quality and inter-observer agreement in FASH vs. remote-FASH ultrasound. J Telemed Telecare. 2013;19:491–493.
    1. Giordani MT, Brunetti E, Binazzi R, Benedetti P, Stecca C, Goblirsch S, Heller T. Extrapulmonary mycobacterial infections in a cohort of HIV-positive patients: ultrasound experience from Vicenza, Italy. Infection. 2013;41:409–414.
    1. Heller T, Goblirsch S, Bahlas S, Ahmed M, Giordani MT, Wallrauch C, Brunetti E. Diagnostic value of FASH ultrasound and chest X-ray in HIV-co-infected patients with abdominal tuberculosis. Int J Tuberc Lung Dis. 2013;17:342–344.
    1. Heller T, Wallrauch C, Goblirsch S, Brunetti E. Focused assessment with sonography for HIV-associated tuberculosis (FASH): a short protocol and a pictorial review. Crit Ultrasound J. 2012;4:21.
    1. Li T, Chen X, Zhen R, Qiu J, Qiu D, Xiao N, Ito A, Wang H, Giraudoux P, Sako Y, et al. Widespread co-endemicity of human cystic and alveolar echinococcosis on the eastern Tibetan Plateau, northwest Sichuan/southeast Qinghai, China. Acta Trop. 2010;113:248–256.
    1. Sperandeo M, De Cata A, Molinaro F, Trovato FM, Catalano D, Simeone A, Varriale A, Martines GF, Trovato G. Ultrasound signs of pulmonary fibrosis in systemic sclerosis as timely indicators for chest computed tomography. Scand J Rheumatol. 2015;44:389–398.
    1. Marchbank ND, Wilson AG, Joseph AE. Ultrasound features of folded lung. Clin Radiol. 1996;51:433–437.
    1. Sperandeo M, Dimitri L, Pirri C, Trovato FM, Catalano D, Trovato GM. Advantages of thoracic ultrasound-guided fine-needle aspiration biopsy in lung cancer and mesothelioma. Chest. 2014;146:e178–e179.
    1. Jacobson JA. Ultrasound in sports medicine. Radiol Clin North Am. 2002;40:363–386.
    1. Rozanski TA, Edmondson JM, Jones SB. Ultrasonography in a forward-deployed military hospital. Mil Med. 2005;170:99–102.
    1. Hile DC, Morgan AR, Laselle BT, Bothwell JD. Is point-of-care ultrasound accurate and useful in the hands of military medical technicians? A review of the literature. Mil Med. 2012;177:983–987.
    1. Madill JJ. In-flight thoracic ultrasound detection of pneumothorax in combat. J Emerg Med. 2010;39:194–197.
    1. de Kerangal X, Tourtier JP, Cotez-Gacia S, Grand B, Borne M. FAST and undertriage. Langenbecks Arch Surg. 2010;395:595–596.
    1. Ward DI. Prehospital point-of-care ultrasound use by the military. Emerg Med Australas. 2007;19:282.
    1. Melanson SW, McCarthy J, Stromski CJ, Kostenbader J, Heller M. Aeromedical trauma sonography by flight crews with a miniature ultrasound unit. Prehosp Emerg Care. 2001;5:399–402.
    1. Otsuka H, Sato T, Morita S, Nakagawa Y, Inokuchi S. A Case of Blunt Traumatic Cardiac Tamponade Successfully Treated by Out-of-hospital Pericardial Drainage in a “Doctor-helicopter” Ambulance Staffed by Skilled Emergency Physicians. Tokai J Exp Clin Med. 2016;41:1–3.
    1. O’Dochartaigh D, Douma M. Prehospital ultrasound of the abdomen and thorax changes trauma patient management: A systematic review. Injury. 2015;46:2093–2102.
    1. Burns BJ, Aguirrebarrena G. Occult traumatic loculated tension pneumothorax--a sonographic diagnostic dilemma. Prehosp Emerg Care. 2013;17:92–94.
    1. Darocha T, Gałązkowski R, Sobczyk D, Żyła Z, Drwiła R. Point-of-care ultrasonography during rescue operations on board a Polish Medical Air Rescue helicopter. J Ultrason. 2014;14:414–420.
    1. Roline CE, Heegaard WG, Moore JC, Joing SA, Hildebrandt DA, Biros MH, Caroon LV, Plummer DW, Reardon RF. Feasibility of bedside thoracic ultrasound in the helicopter emergency medical services setting. Air Med J. 2013;32:153–157.
    1. Ketelaars R, Hoogerwerf N, Scheffer GJ. Prehospital chest ultrasound by a dutch helicopter emergency medical service. J Emerg Med. 2013;44:811–817.
    1. Hasler RM, Kehl C, Exadaktylos AK, Albrecht R, Dubler S, Greif R, Urwyler N. Accuracy of prehospital diagnosis and triage of a Swiss helicopter emergency medical service. J Trauma Acute Care Surg. 2012;73:709–715.
    1. Hoyer HX, Vogl S, Schiemann U, Haug A, Stolpe E, Michalski T. Prehospital ultrasound in emergency medicine: incidence, feasibility, indications and diagnoses. Eur J Emerg Med. 2010;17:254–259.
    1. Bataille B, Riu B, Ferre F, Moussot PE, Mari A, Brunel E, Ruiz J, Mora M, Fourcade O, Genestal M, et al. Integrated use of bedside lung ultrasound and echocardiography in acute respiratory failure: a prospective observational study in ICU. Chest. 2014;146:1586–1593.
    1. Joyner CR. Echocardiography. Circulation. 1972;46:835–838.
    1. Joyner CR. Echocardiography. Am Heart J. 1975;90:413–419.
    1. Joyner CR. Ultrasonic diagnosis of pulmonary embolism--the second time around. Int J Cardiol. 1984;6:116–120.
    1. Kelbel C, Börner N, Schadmand S, Klose KJ, Weilemann LS, Meyer J, Thelen M. Diagnosis of pleural effusions and atelectases: sonography and radiology compared. Rofo. 1991;154:159–163.
    1. Fournier D. [Thoracic ultrasound] Schweiz Med Wochenschr. 1997;127:1734–1742.
    1. Trovato GM, Catalano D, Sperandeo M, Graziano P. Artifacts, Noise and Interference: Much Ado about Ultrasound. Respiration. 2015;90:85.
    1. Tasci O, Hatipoglu ON, Cagli B, Ermis V. Sonography of the chest using linear-array versus sector transducers: Correlation with auscultation, chest radiography, and computed tomography. J Clin Ultrasound. 2016;44:383–389.
    1. Kataoka H, Takada S. The role of thoracic ultrasonography for evaluation of patients with decompensated chronic heart failure. J Am Coll Cardiol. 2000;35:1638–1646.
    1. Kataoka H. Pericardial and pleural effusions in decompensated chronic heart failure. Am Heart J. 2000;139:918–923.
    1. Kataoka H. Utility of thoracic sonography for follow-up examination of chronic heart failure patients with previous decompensation. Clin Cardiol. 2007;30:336–341.
    1. Kataoka H. Ultrasound pleural effusion sign as a useful marker for identifying heart failure worsening in established heart failure patients during follow-up. Congest Heart Fail. 2012;18:272–277.
    1. Oylumlu M, Davutoglu V, Sucu M, Ercan S, Ozer O, Yuce M. Prognostic role of echocardiographic and hematologic parameters in heart failure patients complicated with incidental pleural effusion diagnosed during echocardiographic evaluation. Int J Cardiovasc Imaging. 2014;30:907–910.
    1. Kataoka H, Madias JE. Effects of heart failure status on electrocardiogram precordial leads and their value for monitoring body fluid changes in heart failure patients. Int J Cardiol. 2011;152:113–115.
    1. Trovato GM, Sperandeo M, Catalano D. Optimization of thoracic US guidance for lung nodule biopsy. Radiology. 2014;270:308.
    1. Trovato G, Sperandeo M, Catalano D. Letter to the editor: Mostbeck G. Elastography everywhere--now even the lungs! Ultraschall in Med. 2014; 35: 5 - 8. Ultraschall Med. 2014;35:371; discussion 371–372.
    1. Sperandeo M, Dimitri L, Trovato FM, Simeone A, Catalano D, Pirri C, Trovato G. Thoracic Ultra Sound (TUS) integrated approach for FNAB-US guided diagnosis and for monitoring environmental exposed subjects at risk of malignant pleural mesothelioma (MPM) and lung cancer (LC). Overview and preliminary report of TUS monitoring and screening approach. FASEB J. 2014;28 Suppl:LB498.
    1. Ravin CE. Thoracocentesis of loculated pleural effusions using grey scale ultrasonic guidance. Chest. 1977;71:666–668.
    1. Dede D, Akmangit I, Yildirim ZN, Sanverdi E, Sayin B. Ultrasonography and fluoroscopy-guided insertion of chest ports. Eur J Surg Oncol. 2008;34:1340–1343.
    1. Fitch MT, Nicks BA, Pariyadath M, McGinnis HD, Manthey DE. Videos in clinical medicine. Emergency pericardiocentesis. N Engl J Med. 2012;366:e17.
    1. Trevisani L, Sartori S, Putinati S, Abbasciano V, Cervi PM. Needle aspiration biopsy and ultrasonic guidance. Chest. 1994;106:650.
    1. Sartori S, Nielsen I, Trevisani L, Tombesi P, Ceccotti P, Abbasciano V. Contrast-enhanced sonography as guidance for transthoracic biopsy of a peripheral lung lesion with large necrotic areas. J Ultrasound Med. 2004;23:133–136.
    1. Tombesi P, Nielsen I, Tassinari D, Trevisani L, Abbasciano V, Sartori S. Transthoracic ultrasonography-guided core needle biopsy of pleural-based lung lesions: prospective randomized comparison between a Tru-cut-type needle and a modified Menghini-type needle. Ultraschall Med. 2009;30:390–395.
    1. Di Vece F, Tombesi P, Ermili F, Sartori S. Contrast-enhanced ultrasound (CEUS) and CEUS-guided biopsy in the diagnosis of lung abscess in a patient with achalasia: Case report. Interv Med Appl Sci. 2013;5:31–33.
    1. Boon AJ, Sekiguchi H, Harper CJ, Strommen JA, Ghahfarokhi LS, Watson JC, Sorenson EJ. Sensitivity and specificity of diagnostic ultrasound in the diagnosis of phrenic neuropathy. Neurology. 2014;83:1264–1270.
    1. Bolliger CT, Herth FJF, Mayo, PH Miyazawa T. Clinical Chest Ultrasound. Eds. Progress in Respiratory Research, Vol. 37. Karger: Basel; 2009.
    1. Sperandeo M, Trovato G. Ecografia Toracica. Diagnosi e tecniche interventistiche. Milan: EDRA; 2015.
    1. Trovato GM, Sperandeo M, Catalano D. Computed tomography screening for lung cancer. Ann Intern Med. 2013;159:155.
    1. van Beek EJ, Mirsadraee S, Murchison JT. Lung cancer screening: Computed tomography or chest radiographs? World J Radiol. 2015;7:189–193.
    1. Keddis MT, Cullen MW, Reed DA, Halvorsen AJ, McDonald FS, Takahashi PY, Bhagra A. Effectiveness of an ultrasound training module for internal medicine residents. BMC Med Educ. 2011;11:75.
    1. Fodor D, Badea R, Poanta L, Dumitrascu DL, Buzoianu AD, Mircea PA. The use of ultrasonography in learning clinical examination - a pilot study involving third year medical students. Med Ultrason. 2012;14:177–181.
    1. Fox JC, Schlang JR, Maldonado G, Lotfipour S, Clayman RV. Proactive medicine: the “UCI 30,” an ultrasound-based clinical initiative from the University of California, Irvine. Acad Med. 2014;89:984–989.
    1. Trovato GM, Catalano D, Sperandeo M. Top or Flop: The Need to Improve Knowledge and Skills Achieved by Ultrasound Medical Curricula. Acad Med. 2015;90:839–840.
    1. Chiem AT, Soucy Z, Dinh VA, Chilstrom M, Gharahbaghian L, Shah V, Medak A, Nagdev A, Jang T, Stark E, et al. Integration of Ultrasound in Undergraduate Medical Education at the California Medical Schools: A Discussion of Common Challenges and Strategies From the UMeCali Experience. J Ultrasound Med. 2016;35:221–233.
    1. Dinh VA, Fu JY, Lu S, Chiem A, Fox JC, Blaivas M. Integration of Ultrasound in Medical Education at United States Medical Schools: A National Survey of Directors’ Experiences. J Ultrasound Med. 2016;35:413–419.
    1. Dinh VA, Dukes WS, Prigge J, Avila M. Ultrasound Integration in Undergraduate Medical Education: Comparison of Ultrasound Proficiency Between Trained and Untrained Medical Students. J Ultrasound Med. 2015;34:1819–1824.
    1. Palma JK. Successful strategies for integrating bedside ultrasound into undergraduate medical education. Mil Med. 2015;180:153–157.
    1. Dinh VA, Frederick J, Bartos R, Shankel TM, Werner L. Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education. J Ultrasound Med. 2015;34:43–50.
    1. Dinh VA, Lakoff D, Hess J, Bahner DP, Hoppmann R, Blaivas M, Pellerito JS, Abuhamad A, Khandelwal S. Medical Student Core Clinical Ultrasound Milestones: A Consensus Among Directors in the United States. J Ultrasound Med. 2016;35:421–434.
    1. Dinh VA, Giri PC, Rathinavel I, Nguyen E, Hecht D, Dorotta I, Nguyen HB, Chrissian AA. Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study. Crit Care Res Pract. 2015;2015:675041.
    1. Chiem AT, Chan CH, Ander DS, Kobylivker AN, Manson WC. Comparison of expert and novice sonographers’ performance in focused lung ultrasonography in dyspnea (FLUID) to diagnose patients with acute heart failure syndrome. Acad Emerg Med. 2015;22:564–573.
    1. Moy RJ, Chapman AL, Bapusamy A. The effectiveness of an informal teaching programme for junior doctors identifying pleural effusions using ultrasound at the bedside. J R Army Med Corps. 2010;156:233–235.
    1. Trovato FM, Musumeci G. Lung ultrasound: the need of an adequate training for the next generation of internists. Neth J Med. 2015;73:305.
    1. Catalano D, Trovato FM, Pirri C, Trovato GM. Outpatient diagnosis and therapeutic units linked with ED referrals: a sustainable quality-centered approach. Am J Emerg Med. 2013;31:1612.
    1. Trovato FM, Catalano D. Diagnosis of Pneumonia by Lung Ultrasound in Children and Limited Resources Subsets: A Valuable Medical Breakthrough. Chest. 2016;150:258–260.

Source: PubMed

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