1. Transthoracic US (TTUS) of the Chest Clinical Applications By Hussein Attia MD

2. USES: Evaluation of 1- Peripheral parenchymal 2- Pleural 3- chest wall disease 4- Interventional procedures of the chest wall and pleural space

3. Parenchymal Diseases Pneumonia Pneumonia Neoplasms Neoplasms Heart failure Heart failure Infarct Infarct Round atelectasis Round atelectasis

4. Pleural Diseases Pleural effusion Pleural effusion Pneumothorax Pneumothorax Pleural mass Pleural mass Mesothelioma Mesothelioma

5. Chest wall abnormalities Chest wall tumors Chest wall tumors Rib fractures Rib fractures Other applications Diaphragmatic paralysis US Guided biopsy Thoracocentesis

6. Technique an instrumentations US 2-5 MHz curvilinear probe US 2-5 MHz curvilinear probe High resolution 7.5-10 MHz High resolution 7.5-10 MHz Gray scale and Color Doppler imaging Gray scale and Color Doppler imaging Patient position Patient position a)Raised arm position (in recumbence) b)Posterior chest in sitting, or lateral standing position

7. Sitting Lateral debcubitus Supine suprasternal approach Scanning positioning

8. Normal anatomy

9. Diseases of the Pleural space Anechoic effusion Complex septated pleural effusion Empyema

10. Diseases of the Pleural space Pleural thickening CT mesotheliomaUS mesothelioma

11. Diseases of the Lung Parenchyma Pneumonia and lung abscess Pneumonia and lung abscess US consolidation collapse of right lung lower lobe CD scan showing pulmonary artery branch supplying the collapsed segment

12. Central perihilar masses CT central neoplasmUS central neoplasm demonstrating both mass and lung consolidation M C

13. Neoplasm (Pancoast tumor) US transapical view Plain X ray AP view

14. Round atelectasis US: pleural invagination sign CT: round atelactasis within the left lung base

15. Diseases of the chest wall (lipoma) MRI: T1W Coronal US: 10 MHz

16. Diseases of the chest wall (Hemangioma) MRI: T2W Axial image US linear scan

17. Diseases of the chest wall (lymph nodes) US: Hyperplastic lymph nodeCD: Hyperplastic lymph node

18. Metastatic lymph nodes US: metastatic lymph nodePD: metastatic lymph node

19. Chest wall (rib fracture) US linear scan rib H

20. Mediastinal Intervention Biopsy of mediastinal masses

21. Pleural effusion and basal collapse

22. Normal CPA comet-tail artifact

23. THANK YOU