Diagnostic ultrasound ( PDFDrive )

CHAPTER 50 The Pediatric Chest 1727
A
B
C D E
FIG. 50.39 Ultrasound-Guided Sclerotherapy of Macrocystic Lymphatic Malformation. (A) Sonogram shows multiple cysts within the
right chest wall and axilla extending into the mediastinum. (B) Computed tomography scan shows extent of the lesion. (C) and (D) Sonograms
show needle and dilator, respectively, within the lesion. (E) Sonogram immediately after sclerotherapy injection shows excellent response.
be practical compared with the current usual diagnostic methods
because chest radiographs are quickly and cheaply performed
compared with ultrasound, with a very low radiation dose.
Ultrasound requires more time to perform, is operator dependent,
and may not be practical in critically ill children or in very young
children.
Pneumomediastinum may be misinterpreted on ultrasound
as pneumothorax. 72 In a patient with suspected rib fractures,
radiographs may still be required to look for other fractures.
Severity of bronchiolitis can be determined by ultrasound. 75
However, it can easily be determined by clinical scoring by
evaluating respiratory rate, dyspnea, use of accessory respiratory
muscles, and auscultation. Moderate and severe cases are given
supplementary oxygen. Why would we want to replace a stethoscope
with ultrasound at unnecessary additional cost without
any incremental additional beneit?
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