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ULTRASOUND OF PLEURAL
FLUID COLLECTIONS |
- Anechoic space located peripherally within the thoracic cavity, between the inner chest wall and fetal lung.
- Unilateral or bilateral.
Unilateral
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Bilateral
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Primary
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Secondary
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Isolated
Usually associated with an
underlying structural anomaly: ·
pulmonary lymphangiectasia ·
cystic adenomatoid malformation of the lung ·
bronchopulmonary sequestration ·
diaphragmatic hernia ·
chest wall hamartoma ·
pulmonary vein atresia |
Associated with
other manifestations of hydrops
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subcutaneous skin edema ·
pericardial effusion ·
ascites |
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- Mild = rim of fluid does not completely surround the lung (1), and is found more commonly in the lung bases.
- Moderate = rim of fluid surrounds the lung but less than half of the hemithorax without mediastinal shift.
- Severe = fluid filled more than half of the hemithorax ± mediastinal shift in the case of a unilateral hydrothorax.
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Video clip of
Pleural Effusion & Ascites
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- Partial lung collapse (usually retain their normal shape).
- Hypoplastic lung (may appear as small echogenic masses on either side of the heart) (1).
- ± Mediastinal shift.
- ± Cardiac compression.
- ± Inversion of the diaphragm.
- Other features of fetal hydrops.
- ascites.
- pericardial effusion.
- subcutaneous edema.
- polyhydramnios.
- placental enlargement.
DIFFERENTIAL
DIAGNOSIS
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The presence of significant septations or solid elements within the fluid collection
suggests an alternative diagnosis such as diaphragmatic hernia, cystic
adenomatoid malformation or bronchopulmonary sequestration.
REFERENCES
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- Bovicelli L, Rizzo N, Orsini LF et.al. Ultrasonic real time diagnosis of fetal hydrothorax and lung hypoplasia. J Clin Ultrasound 1981;9:253-254.