Francesco Feletti - Thoracic Ultrasound and Integrated Imaging

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Thoracic ultrasound provides critical diagnostic information in many conditions and situations, which can contribute to a correct diagnosis or therapeutic approach.

Thanks to portable and handheld ultrasound systems, thoracic ultrasound is now available not only at the patients bedside but also outside healthcare facilities and even in wild and remote locations.

Today the method is part of any physicians primary diagnostic resources and doctors must be aware of its role, possibilities and limitations.

This volume collects the contributions of some of the most distingushed experts in this imaging technique, inevitably presenting different points of view due to the different kinds of training and experience of the authors.

Specific attention is paid to the principles governing the formation of images and the role of artefacts which are particularly important aspects in chest sonography because of the abundance of reflective and eco-impermeable elements like air and bone in this area.

Specific chapters are dedicated to thoracic ultrasound applications in neonatology, pediatrics, and emergency medicine as well as guided procedures and diaphragm function studies.

In many cases, the imaging findings are presented together with relevant clinical information and images provided by other imaging methods in order to highlight the role of thoracic ultrasound.

This integrated approach provides medical practitioners with essential know-how for using thoracic ultrasound as an extension of their physical examinations.

Ultrasound images derive from the interaction between ultrasounds and anatomical structures. Ultrasounds are sound waves with frequencies superior to 20 kHz, i.e. higher than the frequency audible by the human ear.

In order to correctly read an ultrasonic image, it is necessary to understand how the ultrasounds interact with biological tissues and how the ultrasound constructs the image. In particular, when studying the thorax, due to pulmonary air and the bones of the ribcage which both alter the propagation of ultrasounds, a perfect reading of both real and artefactual images is indispensable.

In thoracic ultrasound (TUS), the highest frequencies, i.e. those between 5 and 15 MHz, are reserved for the structures of the chest wall, while lower frequencies, i.e. those between 3.5 and 5 MHz, are generally used for exploring the pleura, lungs and mediastinal structures.

Ultrasounds are longitudinal mechanical waves; that is to say, they consist of periodic compressions and rarefactions of the medium.