Chest Diagnostic Imaging Essay
CHEST IMAGING IN THE INTENSIVE CARE UNIT Chest diagnostic imaging is essential when dealing with a critically ill patient. At present, direct visualization of the lung parenchyma is performed with a chest x-ray (CXR) and computed tomography (CT), with the patient in the supine position (Gardelli et al., 2012).
Plain chest radiograph: In the ICU, CXRs are only performed on patients in the supine position. The x-ray beam is positioned directly onto the chest at a distance that is less than satisfactory. In fact, when the x-ray beam does not focus tangentially on the diaphragm dome and the mediastinal structures, a correct diagnosis of the “silhouette sign” may not be achieved. These circumstances may result in diagnostic errors regarding pleural effusions,parenchymal consolidation, and alveolar-interstitial syndrome (Gardelli et al.,2012).
Ultrasound (US): With the advent of portable scanners, US has become an important imaging modality in ICU. It …show more content…
In the past decade, as technology continues to improve, US has made a move from the department to the bedside. First introduced in the emergency department, US was initially used as an adjunct in the trauma bay for the detection of pericardial or free intra-abdominal fluid. Its role has since expanded to the diagnosis of basic intra-abdominal pathology, safer line and tube insertion, among many other uses (Gillman and Kirkpatrick 2012). Because US waves are nearly completely reflected by an air tissue interface, it was originally concluded that “US imaging is not useful for evaluation of the pulmonary parenchyma”. However, recent evidence reveals that an examination of the artifacts produced by LUS results in a lot of information about the underlying lung ( Gillman and Kirkpatrick 2012).
Equipment and Examination
Plain chest radiograph: In the ICU, CXRs are only performed on patients in the supine position. The x-ray beam is positioned directly onto the chest at a distance that is less than satisfactory. In fact, when the x-ray beam does not focus tangentially on the diaphragm dome and the mediastinal structures, a correct diagnosis of the “silhouette sign” may not be achieved. These circumstances may result in diagnostic errors regarding pleural effusions,parenchymal consolidation, and alveolar-interstitial syndrome (Gardelli et al.,2012).
Ultrasound (US): With the advent of portable scanners, US has become an important imaging modality in ICU. It …show more content…
In the past decade, as technology continues to improve, US has made a move from the department to the bedside. First introduced in the emergency department, US was initially used as an adjunct in the trauma bay for the detection of pericardial or free intra-abdominal fluid. Its role has since expanded to the diagnosis of basic intra-abdominal pathology, safer line and tube insertion, among many other uses (Gillman and Kirkpatrick 2012). Because US waves are nearly completely reflected by an air tissue interface, it was originally concluded that “US imaging is not useful for evaluation of the pulmonary parenchyma”. However, recent evidence reveals that an examination of the artifacts produced by LUS results in a lot of information about the underlying lung ( Gillman and Kirkpatrick 2012).
Equipment and Examination