Introduction

Chest ultrasound is reviewed for a variety of applications throughout this book. Literature to support its use in the diagnosis of pneumothorax, hemothorax, and nontraumatic pleural effusions is provided. Indeed, this literature lends support to the superiority of ultrasound as a diagnostic modality over chest x-ray for many applications. In addition, the patient safety benefits of ultrasound when performing procedures such as thoracentesis are presented.

Not surprisingly, there is more. With increased use of chest ultrasound in the intensive care unit setting has come a wider range of applications for its use. The role of chest ultrasound in the diagnosis of pulmonary edema or extravascular lung water (EVLW) is reviewed in this chapter. More important, the terminology that has been developed by pioneers in thoracic ultrasound and the concepts behind it are described because they are crucial to the diagnostic use of chest ultrasound for all chest applications.

The two most basic concepts – A lines and B lines – are described. For more detailed descriptions of these and other chest ultrasound applications, sonographers are encouraged to read Dr. Daniel A. Lichtenstein's book, General Ultrasound in the Critically Ill (1).

Focused questions for chest ultrasound

The questions for chest ultrasound are as follows:

1. Are A lines present?

2. Are B lines present?

Anatomy

When using ultrasound to make diagnoses in lung pathology, it is important to recall some of the basic principles described in Chapter 1.