الفهرس 
Normal sonographic appearanceOnly 14 pages are availabe for public view
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Abstract
Examination of the chest is a rapidly developing application of ultrasound and it is well established as a useful imaging method in the differential diagnosis of pleural lesions, peripheral pulmonary lesions, mediastinal masses, and chestwall lesions. Ultrasound may be helpful in the evaluation of persistent or puzzling areas of increased opacities in the peripheral lung, pleural abnormalities and mediastinal widening in plain radiography. It is particularly useful in patients with complete opacification of a hemithorax at chest radiography. The technique lends itself to bedside use in the intensive care unit, where suboptimal radiography may mask or mimic clinically significant abnormalities. Furthermore, it is increasingly used to guide interventional procedures of the chest and pleural space. The aim of this work was to evaluate the role of ultrasonography in assessment of different pediatric chest diseases and comparing the results with chest CT whenever indicated. Our study comprised 51 patients, 22 of them were males and 29 were females. Their age ranged from 1 day up to 16 years. All patients were suffering from chest related complaints. Chest radiographs were done for all cases, All were reviewed together with CT scan of the chest if was done prior to chest ultrasound to localize the area of interest. The results of our patients are classified into four main groups according to the site of the pathology. Group(I): this group included pleural disorders. Ultrasound was helpful in differentiation between the pleural fluids, thickening, and masses. Moreover it can characterize the nature of pleural effusions and detect the degree of complexity of effusion more than CT. Group(II): this group was concerned with parenchymal lung disorders, including consolidation, collapse, and lung cavitations and were successfully evaluated by US. Lung cavitations can be detected by US earlier than CT. Group(III): this group included patients with mediastinal disorders. Suprasternal, parasternal approaches were helpful in screening superior, and anterior mediastinum, paratracheal areas, and pericardial regions. US can be considered a valuable alternative in assessment of thymus gland simulating a mediastinal mass in a child and even replace CT and MRI. The lesions at the aortopulmonary window, the subcarinal, the paravertebral regions and the posterior mediastinum were adequately evaluated by CT more than US. Group(IV): this group included Chest wall lesions and US was helpful in evaluation of chest wall masses, characterizing its nature, localizing its origin and detection of osseous involvement or pleural invasion. Color Doppler US has many potential applications in chest diseases. It helped us in detection of minimal effusions owing to the ?fluid color sign? , differentiation between benign and malignant lesions, and guiding transthoracic needle biopsy. Regarding US guided interventional procedures of the chest, US proved to be effective, safe, and more convenient than Fluoroscopy or CT specially in lesions abutting the chest wall. US has the great advantage that no radiation exposure. Also it is a realtime which can be operated at any direction with shorter procedure time. In conclusion: Chest ultrasonography is helpful in evaluation of a wide range of pleural, parenchymal, mediastinal and chest wall lesions and ideally suited for imaging of the pleura. Chest US should be the second step after plain radiography, prior to CT scans in the evaluation of peripheral chest lesions , puzzling areas of increased opacities or in cases of opaque hemithorax to avoid unnecessary CT exposure in some cases. US of the mediastinum has several limitations. Successful examination requires considerable experience in US, well visual interpretation, and a thorough knowledge of anatomic structures. But it is a reliable method and sometimes may replace CT and MRI to avoid unnecessary investigations of a normal thymus. Sonographic findings should be compared with those of chest radiograph or chest CT to attain the highest accuracy in interpretation and it can be a supplementary method for areas requiring more detailed views. Chest US can be helpful especially when CT is not available and is particularly suited for critically ill patients Chest US should be the modality of choice for guidance of interventional procedures especially pleural lesions and peripheral parenchymal lesions if pleurally based.