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胸腔超音波在急重症之

臨床應用

胸腔超音波在急重症之

臨床應用

臺大醫院創傷醫學部整合醫學科

樹金忠醫師

Chest US at ED and ICUChest US at ED and ICU

� Pleural effusion

� Pneumothorax

� Pneumonia and lung abscess

� Pulmonary embolism

� Pulmonary edema

� Lung cancer and metastasis

� Other application

Pleural effusionPleural effusion

� Echo-free zone

� Change shape with respiration

� Flow color sign

Echo free zone

Expiration Inpiration

Change shape with respiration

Flow color sign

Wu RG,J Ultrasound Med 1995; 14:767-769

� Anechoic

� Complex, nonseptated

� Complex, septated

� Homogeneous echogenic

Pleural effusion-Character

Yang PC, Am J Roentgenol. 1992;159:29-33.

Anechoic Complex non-septated

Complex septatedHomogeneous hyperechoic

� Anechoic-

Transudate or exudate

� Complex septated, complex nonseptated, or

homogeneously echogenic pattern-

Exudate

� Thickened pleura- exudate

� Parenchyma lesion-exudate

� Homogeneous echogenic- hemorrhagic effusion or

empyema

� Pleural nodule- malignant effusion

Value of US in Determining the Nature of Pleural Effusion

AJR 1992; 159:29


Sonographic Patterns and Nature of Pleural Effusion in 320 Patients

Effusions

Internal EchogenicityThickened

pleura

(76)

Pleural

Nodule

(10)

Parench

ymal

Lesions

(54)

Anechoic

(172)

Complex

Nonseptated

(50)

Complex

Septated

(76)

Homogeneo

usly

Echogenic

(22)

Transudate

(96)

96 0 0 0 3 0 3

Exudate

Nonmalignant

(111)

30 27 40 14 42 0 38

Malignant

(113)

46 23 36 8 31 10 13

AJR 1992; 159:29


Nature of Effusion

Transudate Exudate

CHF Non-malignant

Liver cirrhosis Parapneumonic effusion

Nephrotic syndrome TB pleurisy

Hypoalbuminemia Collagen diseases

Hemothorax

Postcardiotomy syndrome

Malignant

AJR 1992; 159:29

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