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Abstract

Ultrasound is the most important imaging modality in children and can play an important role in evaluation of the pediatric chest. Typical questions may be the evaluation of a thymic enlargement or mass, or the character of a pleural effusion. By using appropriate equipment and expertise, ultrasound can provide important information without the need for any other radiating imaging modality. This chapter describes the most important diagnoses, which can be evaluated by chest ultrasound from the view of a pediatric surgeon. The ultrasound appearance of normal conditions as well as different diseases is described, its role and limitations discussed and the need for further imaging recommended where appropriate.

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References

  1. Ben-Ami TE, O’Donovan JC, Yousefzadeh DK. Sonography of the chest in children. Radiol Clin North Am. 1993;31(3):517–31.

    CAS  PubMed  Google Scholar 

  2. Mong A, Epelman M, Darge K. Ultrasound of the pediatric chest. Pediatr Radiol. 2012;42(11):1287–97.

    Article  PubMed  Google Scholar 

  3. Coley BD. Chest sonography in children: current indications, techniques, and imaging findings. Radiol Clin North Am. 2011;49(5):825–46.

    Article  PubMed  Google Scholar 

  4. Volpicelli G. Sonographic diagnosis of pneumothorax. Intensive Care Med. 2011;37(2):224–32.

    Article  PubMed  Google Scholar 

  5. Barillari A, Kiuru S. Detection of spontaneous pneumothorax with chest ultrasound in the emergency department. Intern Emerg Med. 2010;5(3):253–5.

    Article  PubMed  Google Scholar 

  6. Lapegue F, Faruch-Bilfeld M, Demondion X, Apredoaei C, Bayol MA, Artico H, et al. Ultrasonography of the brachial plexus, normal appearance and practical applications. Diagn Interv Imagin. 2014;95(3):259–75.

    Article  CAS  Google Scholar 

  7. Francis IR, Glazer GM, Bookstein FL, Gross BH. The thymus: reexamination of age-related changes in size and shape. AJR Am J Roentgenol. 1985;145(2):249–54.

    Article  CAS  PubMed  Google Scholar 

  8. Kim OH, Kim WS, Kim MJ, Jung JY, Suh JH. US in the diagnosis of pediatric chest diseases. Radiographics: a review publication of the Radiological Society of North America Inc. 2000;20(3):653–71.

    Article  CAS  Google Scholar 

  9. Ja T. Mediastinal Tumors. In: Gw H, Editor. Ashcraft’s pediatric surgery. Miamisburg: Elsevier; 2014. p. 341–50.

    Google Scholar 

  10. Fonseca AL, Ozgediz DE, Christison-Lagay ER, Detterbeck FC, Caty MG. Pediatric thymomas: report of two cases and comprehensive review of the literature. Pediatr Surg Int. 2014;30(3):275–86.

    Article  PubMed  Google Scholar 

  11. Castro D, Derisavifard S, Anderson M, Greene M, Iannaccone S. Juvenile myasthenia gravis: a twenty-year experience. J Clin Neuromuscul Dis. 2013;14(3):95–102.

    Article  PubMed  Google Scholar 

  12. Azizkhan RG, Dudgeon DL, Buck JR, Colombani PM, Yaster M, Nichols D, et al. Life-threatening airway obstruction as a complication to the management of mediastinal masses in children. J Pediatr Surg. 1985;20(6):816–22.

    Article  CAS  PubMed  Google Scholar 

  13. Kawashima A, Fishman EK, Kuhlman JE, Nixon MS. CT of posterior mediastinal masses. Radiographics: a review publication of the Radiological Society of North America. Inc. 1991;11(6):1045–67.

    Article  CAS  Google Scholar 

  14. Sidani AH, Oberson R, Deleze G, Barras MH, Genton N, Laurini R. Infected teratoma of lower posterior mediastinum in a six-year-old boy. Pediatr Radiol. 1991;21(6):438–9.

    Article  CAS  PubMed  Google Scholar 

  15. Demondion X, Herbinet P, Van Sint JS, Boutry N, Chantelot C, Cotten A. Imaging assessment of thoracic outlet syndrome. Radiographics. 2006;26(6):1735–50.

    Article  PubMed  Google Scholar 

  16. Farrar TA, Rankin G, Chatfield M. Venous thoracic outlet syndrome: approach to diagnosis and treatment with focus on affected athletes. Curr Sports Med Rep. 2014;13(2):81–5.

    Article  PubMed  Google Scholar 

  17. Abiri MM, Kirpekar M, Ablow RC. Osteomyelitis: detection with US. Radiology. 1989;172(2):509–11.

    Article  CAS  PubMed  Google Scholar 

  18. Kelloff J, Hulett R, Spivey M. Acute rib fracture diagnosis in an infant by US: a matter of child protection. Pediatr Radiol. 2009;39(1):70–2.

    Article  PubMed  Google Scholar 

  19. Faber LP, Somers J, Templeton AC. Chest wall tumors. Curr Probl Surg. 1995;32(8):661–747.

    Article  CAS  PubMed  Google Scholar 

  20. Dubois J, Patriquin HB, Garel L, Powell J, Filiatrault D, David M, et al. Soft-tissue hemangiomas in infants and children: diagnosis using Doppler sonography. AJR Am J Roentgenol. 1998;171(1):247–52.

    Article  CAS  PubMed  Google Scholar 

  21. Dubois J, Garel L, David M, Powell J. Vascular soft-tissue tumors in infancy: distinguishing features on Doppler sonography. AJR Am J Roentgenol. 2002;178(6):1541–5.

    Article  PubMed  Google Scholar 

  22. Paltiel HJ, Burrows PE, Kozakewich HP, Zurakowski D, Mulliken JB. Soft-tissue vascular anomalies: utility of US for diagnosis. Radiology. 2000;214(3):747–54.

    Article  CAS  PubMed  Google Scholar 

  23. Yang PC, Luh KT, Chang DB, Wu HD, Yu CJ, Kuo SH. Value of sonography in determining the nature of pleural effusion: analysis of 320 cases. AJR Am J Roentgenol. 1992;159(1):29–33.

    Article  CAS  PubMed  Google Scholar 

  24. Lomas DJ, Padley SG, Flower CD. The sonographic appearances of pleural fluid. Br J Radiol. 1993;66(787):619–24.

    Article  CAS  PubMed  Google Scholar 

  25. Pillai D, Song X, Pastor W, Ottolini M, Powell D, Wiedermann BL, et al. Implementation and impact of a consensus diagnostic and management algorithm for complicated pneumonia in children. J Investig Med. 2011;59(8):1221–7.

    Article  PubMed  Google Scholar 

  26. St. Peter S. Acquired lesions of the lung and pleura. In: GW. H, editor. Ashcraft’s pediatric surgery. Miamisburg: Elsevier Inc; 2014. p. 302–14.

    Google Scholar 

  27. Wu RG, Yang PC, Kuo SH, Luh KT. “Fluid color” sign: a useful indicator for discrimination between pleural thickening and pleural effusion. J Ultrasound Med. 1995;14(10):767–9.

    CAS  PubMed  Google Scholar 

  28. Tsao K, Lally K. Congenital diaphragmatic hernia and eventration. In: GW. H, editor. Ashcraft’s pediatric surgery. Miamisburg: Elsevier Inc; 2014.

    Google Scholar 

  29. Bih LI, Wu YT, Tsai SJ, Tseng FF, Lin CY, Ding H. Comparison of ultrasonographic renal excursion to fluoroscopic diaphragmatic excursion for the assessment of diaphragmatic function in patients with high cervical cord injury. Arch Phys Med Rehabil. 2004;85(1):65–9.

    Article  PubMed  Google Scholar 

  30. Epelman M, Navarro OM, Daneman A, Miller SF. M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients. Pediatr Radiol. 2005;35(7):661–7.

    Article  PubMed  Google Scholar 

  31. Durant A, Nagdev A. Ultrasound detection of lung hepatization. West J Emerg Med. 2010;11(4):322–3.

    PubMed  PubMed Central  Google Scholar 

  32. Weinberg B, Diakoumakis EE, Kass EG, Seife B, Zvi ZB. The air bronchogram: sonographic demonstration. AJR Am J Roentgenol. 1986;147(3):593–5.

    Article  CAS  PubMed  Google Scholar 

  33. Yang PC, Luh KT, Chang DB, Yu CJ, Kuo SH, Wu HD. Ultrasonographic evaluation of pulmonary consolidation. Am Rev Respir Dis. 1992;146(3):757–62.

    Article  CAS  PubMed  Google Scholar 

  34. Lichtenstein DA. Ultrasound in the management of thoracic disease. Crit Care Med. 2007;35(5 Suppl):S250–61.

    Article  PubMed  Google Scholar 

  35. Lichtenstein D, Meziere G, Seitz J. The dynamic air bronchogram. A lung ultrasound sign of alveolar consolidation ruling out atelectasis. Chest. 2009;135(6):1421–5.

    Article  PubMed  Google Scholar 

  36. Ding W, Shen Y, Yang J, He X, Zhang M. Diagnosis of pneumothorax by radiography and ultrasonography: a meta-analysis. Chest. 2011;140(4):859–66.

    Article  PubMed  Google Scholar 

  37. Lichtenstein DA, Menu Y. A bedside ultrasound sign ruling out pneumothorax in the critically ill. Lung sliding. Chest. 1995;108(5):1345–8.

    Article  CAS  PubMed  Google Scholar 

  38. Lichtenstein D, Meziere G, Biderman P, Gepner A, Barre O. The comet-tail artifact. An ultrasound sign of alveolar-interstitial syndrome. Am J Respir Crit Care Med. 1997;156(5):1640–6.

    Article  CAS  PubMed  Google Scholar 

  39. Lichtenstein D, Meziere G, Biderman P, Gepner A. The “lung point”: an ultrasound sign specific to pneumothorax. Intensive Care Med. 2000;26(10):1434–40.

    Article  CAS  PubMed  Google Scholar 

  40. Han BK, Suh YL, Yoon HK. Thymic ultrasound. I. Intrathymic anatomy in infants. Pediatr Radiol. 2001;31(7):474–9.

    Article  CAS  PubMed  Google Scholar 

  41. Moseme T, Andronikou S. Through the eye of the suprasternal notch: point-of-care sonography for tuberculous mediastinal lymphadenopathy in children. Pediatr Radiol. 2014;44(6):681–4.

    Article  PubMed  Google Scholar 

  42. Bar-Ziv J, Barki Y, Maroko A, Mares AJ. Rib osteomyelitis in children. Early radiologic and ultrasonic findings. Pediatr Radiol. 1985;15(5):315–8.

    Article  CAS  PubMed  Google Scholar 

  43. Gross BR, D’Agostino C, Coren CV, Petrikovsky BP. Prenatal and neonatal sonographic imaging of a central diaphragmatic hernia. Pediatr Radiol. 1996;26(6):395–7.

    Article  CAS  PubMed  Google Scholar 

  44. Kaude JV, Laurin S. Ultrasonographic demonstration of systemic artery feeding extrapulmonary sequestration. Pediatr Radiol. 1984;14(4):226–7.

    Article  CAS  PubMed  Google Scholar 

  45. de Vreede I, Bilardo CM, van Rijn RR, Clur SA, Heij HA. Intrapericardial extralobar pulmonary sequestration presenting as a prenatal intrathoracic mass. Pediatr Cardiol. 2008;29(5):980–2.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Stefan Scholz MD, FACS, FAAP .

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Leeper, C., Gödeke, J., Scholz, S. (2016). The Thorax. In: Scholz, S., Jarboe, M. (eds) Diagnostic and Interventional Ultrasound in Pediatrics and Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-21699-7_4

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  • DOI: https://doi.org/10.1007/978-3-319-21699-7_4

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