Contrast-enhanced ultrasonography in peripheral lung consolidations: What’s its actual role?

Figure 1 Absence of arterial enhancement. A: transverse sonogram of the right chest wall in the sixth posterior intercostal space showing an inhomogeneous mass in the pleural space; B: transverse contrast-enhanced sonogram of the mass showing complete absence of enhancement in the arterial phase. Final diagnosis was haemothorax with a large clot.

Figure 2 Early arterial enhancement. A: Transverse sonogram showing parenchymal consolidation of the lower lobe of the right lung (arrow); B: Transverse contrast-enhanced sonogram in the arterial phase showing clear enhancement of the lung consolidation (large arrow); the enhancement of the liver is still starting (thin arrow). Final diagnosis was slow resolution pneumonia.

Figure 3 Delayed arterial enhancement. A: Tranverse sonogram of the left chest wall in the seventh intercostal space along the mid-axillary line showing an isoechoic pleural nodule, pleural effusion (thin arrows), and spleen (large arrow); B: Transverse contrast-enhanced sonogram in the arterial phase showing inhomogeneous enhancement of the nodule (thin arrow) that occurs contemporaneously to the enhancement of the spleen (large arrow) (left side of the split-screen); the enhancement of the nodule is less marked than that of the spleen. Final diagnosis was pleural metastasis from colon cancer.

Figure 4 Marked and homogeneous arterial enhancement. Left side of the split-screen: transverse sonogram of the left chest wall in the sixth intercostal space showing loculated pleural effusion (thin arrow) and pulmonary consolidation. Right side of the split screen: contrast-enhanced sonogram showing homogeneous and marked enhanced of the pulmonary consolidation with respect to the chest wall (large arrow). Final diagnosis was compressive atelectasis.