Thoracic Interventions: The Role of Ultrasound Guidance for Diagnostic and Therapeutic Procedures

Abstract

In recent years, ultrasound has assumed a major role in imaging-guided percutaneous thoracic interventions. Ultrasound guidance for thoracic interventions began as an application of techniques in the thorax that had been developed originally for abdominal biopsies and drainages. Advances in ultrasound technology and the development of techniques and catheters specifically designed for use in the thorax have contributed to the increasing use of ultrasound guidance for thoracic interventions. Once used most often when other guided or unguided interventions had failed or were not feasible, ultrasound has become the preferred method of guidance for many thoracic procedures. This review will update the current application of ultrasound guidance for diagnostic and therapeutic percutaneous thoracic interventions, inducing biopsies of the lung, mediastinum, and pleura as well as diagnostic aspiration and therapeutic drainage of pleural collections. Pleurodesis for malignant effusions and fibrinolytic therapy for empyema and hemothorax also will be considered. Technique, success rate, and complications will be discussed.

Keywords:

Ultrasound (US) guidance - lung, biopsy - mediastinum, biopsy - empyema - intrapleural fibrinolysis - sclerotherapy