1Shioya Clinic of Internal Medicine, 2Department of Internal Medicine, Saiseikai Nara Hospital, 3Department of Internal Medicine, Heisei Memorial Hospital, 4Department of Endoscopy and Ultrasound, Nara Medical University, 5the Second Department of Internal Medicine, Nara Medical University
ultrasonography of respiratory tract, lung cancer enhanced ultrasonography, B-Flow color, lung echo
The clinical application of ultrasonography for the respiratory tract started in the latter half of 1970 with B-mode ultrasound. Ultrasonography is useful for diagnosis and evaluation of chest wall lesions, costal lesions, pleural lesions, pleural effusion, lung lesions in contact with the pleura (subpleural lesions), pleural invasion of lung cancer, and mediastinal lesions. Ultrasonography is also useful for ultrasound-guided biopsy and the support during bronchoscopy. Recently, the usefulness of ultrasonography has gained attention in emergency cases requiring anesthesiology and in the emergency room, e.g., pneumothorax and lung edema. The diagnosis of lung lesions in contact with the pleura has limits with use of B-mode alone, but the diagnostic ability improves by adding blood flow information. Diagnosis by means of ultrasound blood flow imaging of the respiratory tract was subsequently introduced. Power Doppler, 3D, B-Flow color, and enhanced ultrasonography with Levovist® and Sonazoid® enable the detailed blood flow diagnosis in the respiratory tract. Blood flow diagnosis is also useful for the evaluation of ultrasound-guided biopsy and the response to therapy for lung cancer. Like other areas where it is used, ultrasonography of the respiratory tract is very useful.