Clinical Chest Ultrasound: From the ICU to the Bronchoscopy Suite Progress in Respiratory Research Vol. 37 Series Editor Chris T. Bolliger Cape Town Clinical Chest Ultrasound From the ICU to the Bronchoscopy Suite Volume Editors C.T. Bolliger Cape Town F.J.F. Herth Heidelberg P.H. Mayo New Hyde Park, N.Y. T. Miyazawa Kawasaki J.F. Beamis Burlington, Mass. 214 figures, 41 in color, 11 tables, and online supplementary material, 2009 Basel · Freiburg · Paris · London · New York · Bangalore · Bangkok · Shanghai · Singapore · Tokyo · Sydney Prof. Dr. Chris T. Bolliger Prof. Dr. Teruomi Miyazawa Department of Medicine Division of Respiratory and Infectious Diseases Faculty of Health Sciences Department of Internal Medicine University of Stellenbosch St. Marianna University School of Medicine 19063 Tygerberg 7505, Cape Town (South Africa) 2-16-1 Sugao miyamae-ku Kawasaki, Kanagawa 216-8511 (Japan) Prof. Dr. Felix J.F. Herth Department of Pneumology and Critical Care Medicine Dr. John F. Beamis Thoraxklinik, University of Heidelberg Section Pulmonary and Critical Care Medicine Amalienstrasse 5 Lahey Clinic DE-69126 Heidelberg (Germany) 41 Mall Road Burlington, MA 01805 (USA) Dr. Paul H. Mayo Long Island Jewish Medical Center Division of Pulmonary, Critical Care, and Sleep Medicine 410 Lakeville Road New Hyde Park, NY 11040 (USA) Library of Congress Cataloging-in-Publication Data Clinical chest ultrasound : from the ICU to the bronchoscopy suite / volume editors, C.T. Bolliger ... [et al.]. p. ; cm. -- (Progress in respiratory research ; v. 37) Includes bibliographical references and index. ISBN 978-3-8055-8642-9 (hard cover : alk. paper) 1. Chest--Ultrasonic imaging. I. Bolliger, C. T. (Christoph T.) II. Series: Progress in respiratory research ; v. 37. [DNLM: 1. Thoracic Diseases--ultrasonography. 2. Thorax--ultrasonography. W1 PR681DM v.37 2009 / WF 975 C641 2009] RC941.C647 2009 617.5’407543--dc22 2009000811 Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents®. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. © Copyright 2009 by S. Karger AG, P.O. Box, CH–4009 Basel (Switzerland) www.karger.com Printed in Switzerland on acid-free and non-aging paper (ISO 9706) by Reinhardt Druck, Basel ISSN 1422–2140 ISBN 978–3–8055–8642–9 e-ISBN 978–3–8055–8643–6 Contents Foreword VII Preface VIII The Basics Chapter 1 Physics of Diagnostic Ultrasound 2 Creating the Image Reuter, K.L.; Bogdan, A. (Burlington, Mass.) Chapter 2 Thoracic Ultrasound Overview 11 Islam, S. (Columbus, Ohio); Tonn, H. (Hannover) Transthoracic Ultrasound Chapter 3 Transthoracic Ultrasound for Chest Wall, Pleura, and the Peripheral Lung 22 Koegelenberg, C.F.N.; Diacon, A.H.; Bolliger, C.T. (Cape Town) Chapter 4 Ultrasound of the Neck 34 Kreuter, M.; Delorme, S. (Heidelberg); Schuler, A. (Geislingen); Herth, F.J.F. (Heidelberg) Chapter 5 Diagnosis of Pulmonary Embolism and Pneumonia Using Transthoracic Sonography 43 Reissig, A.; Kroegel, C. (Jena) Chapter 6 The Mediastinum 51 Herth, F.J.F. (Heidelberg) Critical Care Applications Chapter 7 Critical Care Echocardiography 60 Mayo, P.H. (New Hyde Park, N.Y.) Chapter 8 Use of Ultrasound for Central Venous Access 69 Garibaldi, B.; Feller-Kopman, D. (Baltimore, Md.) Chapter 9 Ultrasound Evaluation of the Lung 76 Pellecchia, C. (New York, N.Y.); Mayo, P.H. (New Hyde Park, N.Y.) Chapter 10 Pleural Ultrasonography in the Intensive Care Unit 82 Wang, J.S.; Doelken, P. (Charleston, S.C.) V Chapter 11 Abdominal Ultrasonography as Related to Problems of the Chest 89 Beckh, S.; Kirchpfening, K. (Nürnberg) Chapter 12 Use of Ultrasonography for the Diagnosis of Venous Thromboembolic Disease 96 Kaplan, A.E. (McAllen, Tex.); Kory, P. (New York, N.Y.) Endoscopic Ultrasound Applications Chapter 13 Principles and Practice of Endoscopic Ultrasound 110 Nishina, K.; Hirooka, K. (Tokyo); Wiegand, J.; Dremel, H. (Hamburg) Chapter 14 Short History of the Development of Endobronchial Ultrasound – A Story of Success 128 Becker, H.D. (Heidelberg) Chapter 15 State-of-the-Art Equipment and Procedures 140 Kurimoto, N.; Osada, H.; Miyazawa, T. (Kawasaki) Chapter 16 Convex Probe Endobronchial Ultrasound 147 Yasufuku, K. (Toronto, Ont.); Nakajima, T. (Chiba) Chapter 17 Endobronchial Ultrasound for Staging of Lung Cancer 153 Herth, F.J.F. (Heidelberg) Chapter 18 Endobronchial Ultrasonography for Peripheral Pulmonary Lesions 160 Kurimoto, N.; Osada, H.; Miyazawa, T. (Kawasaki) Chapter 19 Esophageal Ultrasound 166 Annema, J.T.; Rabe, K.F. (Leiden) Chapter 20 Competing Technologies: Ultrasound, Navigational Bronchoscopy, Optical Coherence Tomography, etc. – Who Will Win Out? 171 Lee, P. (Singapore); Beamis, J.F. (Burlington, Mass.) Ultrasound and Therapeutic Procedures Chapter 21 Ultrasound and Medical Thoracoscopy 182 Michaud, G.; Ernst, A. (Boston, Mass.) Chapter 22 Endobronchial Ultrasound for Difficult Airway Problems 189 Shirakawa, T.; Ishida, A.; Miyazu, Y.; Kurimoto, N. (Kawasaki); Iwamoto, Y. (Hiroshima); Nobuyama, S.; Miyazawa, T. (Kawasaki) Chapter 23 Ultrasound Guidance for Endoscopic Treatment of Pulmonary Malignancies 202 Eberhardt, R. (Heidelberg); Bugalho, A. (Lisbon) Chapter 24 Ultrasound-Guided Drainage Procedures and Biopsies 208 Wang, J.S.; Doelken, P. (Charleston, S.C.) Author Index 215 Subject Index 216 V ideo Online supplementary material, www.karger.com/PRR037_suppl VI Contents Foreword This current volume on Clinical Chest Ultrasound: From the A book on imagery tools should include as many illus- ICU to the Bronchoscopy Suite is the 37th in the series, and trations as possible without overdoing it and becoming an the 10th since I took over as Editor-in-Chief. For this cele- atlas, which was clearly not our aim. We therefore made use bratory 10th volume I wanted to have an unusual topic, but of the electronic option to put a number of pictures and one that would perfectly reflect the spirit of Progress in more importantly all video clips on a special on-line repos- Respiratory Research. When talking to potential guest editors itory open to the purchaser of the book. We hope that this for the book John Beamis, a friend and well-known interven- feature will be attractive to the reader especially since these tional pulmonologist from Boston, came up with the bril- illustrations can also be downloaded for personal use. liant idea to choose ultrasound as the topic and to cover all The final product should meet the very high standards of aspects of its use in the chest that might be of interest to pul- the book series, which — by the way — has seen two of its monologists and intensivists. The above title was born. The latest volumes receive a ‘highly commended’ award in the next step was to find guest editors who would be willing to BMA Book Competition! In the future we will continue to do this book together with me, and bring the necessary produce about one book a year about any important aspect knowledge to cover every angle of this new imaging tool. I of chest medicine. But while waiting for upcoming vol- was delighted that we could get the support of John Beamis umes, get this one and enjoy it! for the introductory section, Paul Mayo for the intensive care C.T. Bolliger unit part, Felix Herth for the endoscopic ultrasound section, Cape Town and Teruomi Miyazawa for the therapeutic procedures, while I covered the transthoracic applications. VII Preface The use of ultrasound in medicine began during and In case of parabronchial lesions, for instance, the view shortly after the 2nd World War in various centres around during bronchoscopy is limited to the inner surface, the world. The work of Dr. Karl Theodore Dussik in whereas the addition of endobronchial ultrasound systems Austria in 1942 on transmission ultrasound investigation of allows the inspection of structures surrounding the airways. the brain is the first published work on medical ultrasonics. The various applications of chest ultrasound are set to From the mid-1960s onwards, the advent of commer- become practical and essential tools for the pulmonologist cially available systems allowed the wider dissemination of in the near future. the art. Rapid technological advances in electronics and However, the medical use of ultrasound remains highly piezoelectric materials provided further improvements operator dependent in spite of advances in technology, and from bistable to greyscale images and from still images to the interests of the patient are best served by the provision real-time moving images. The technical advances at this of an ultrasound service which offers the maximum clinical time led to a rapid growth in the applications to which benefit and optimal use of resources, i.e.