Video-assisted thoracic surgery ultrasound (VATS-US) in the evaluation of subpleural disease: preliminary report of a systematic study

摘要

VATS (a), VATS-US (b), TUS (c), and CT (d) images of a tobacco smoker with no fibrosis undergoing resection of pulmonary metastasis from colon adenocarcinoma in comparison with the same images in a patient with a final diagnosis of UIP (e–h). a VATS pattern of patient with no fibrosis; b VATS-US image (linear intraoperative probe, 10 MHz) showing a thin hyperechoic pleural surface (white arrow) in the absence of artifacts; c TUS image (convex probe, 5 MHz) showing a hyperechoic and thin (2.6 mm) pleural line and artifacts below it (B-lines); d CT axial scan of the same image visualized at TUS (blue box) showing no fibrosis; e VATS image of patient with UIP; f VATS-US pattern (intraoperative linear probe) of increased thickness of the pleural line with no artifact below; g TUS image showing irregular thickening of the hyperechoic pleural line (5 mm) and B-line below (white arrow). h HRCT axial scan of the same image visualized at TUS (blue box) showing a pattern of fibrosis