Chest Sonography

Preface
The scope of application of chest sonography has been
significantly widened in the last few years. Portable ultrasound
systems are being used to an increasing extent in
preclinical sonography, at the site of trauma, in the ambulance
of the emergency physician or in ambulance
helicopters. In the emergency room, at the intensive care
unit and in clinical routine, chest sonography has proved
its worth as a strategic instrument to be used directly
after the clinical investigation. It helps the investigator to
decide—very rapidly—whether a traumatized patient is
suffering such severe internal hemorrhage that he needs
to be transported to the operating room immediately or
whether there still is time for further investigations like
CT. Several diagnoses such as pneumothorax, pneumonia
or pulmonary embolism can be established immediately.
Numerous recent publications have significantly
deepened our knowledge of chest sonography: the sonomorphology
of the normal pleura has been described
more accurately on cadavers and in histological sections.
The sonoanatomy of the upper aperture of the thorax has
been extended to include imaging of the brachial plexus,
which allows more precise administration of regional anesthesia
and the application of a smaller quantity of the
anesthetic. Monumental studies on lymph node staging
in the presence of bronchial carcinoma have been presented.
Here sonography is markedly superior to CT. The
high value of endoluminal accesses has been explained in
greater detail and with greater precision.
The present new issue has been extended to include
two subjects. Contrast sonography is currently at the
threshold of being introduced for the differentiation of
subpleural lung lesions—in some instances the sonomorphology
of the B-mode image and color-Doppler sonography
are still ambiguous. The second new section is an
elucidation of clinical sonography from symptoms to diagnosis.
I am most deeply indebted to the team of authors for
their creative cooperation and timely submissions. I also
thank Springer-Verlag for their close collaboration and
careful production of the book.
The purpose of this pictorial atlas is to help colleagues
serve their patients better. It will hopefully enable clinicians
to establish diagnoses rapidly at the patient’s bedside
with greater accuracy and efficiency, and to initiate
appropriate therapeutic measures on time.

Rankweil, August 2007
Gebhard Mathis

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