US FINDINGS IN DYNAMIC OBSERVATION OF LUNG CONTUSION IN PATIENTS WITH BLUNT THORACIC TRAUMA

Purpose: The purpose was to investigate the diagnostic potential of dynamic thoracic ultrasonography (US) in patients with severe blunt thoracic trauma (BTT). Methods and Materials: Thoracic US examinations were performed in 35 patients with BTT 1–2 times a day during the 1st week, once in 3–4 days during the following 2 weeks, and later on once a week until the patient's recovery. Results: On the 1st-2nd day of admission, the US in all the patients showed the loss of lung airiness (lung contusion). In 10 patients treated with lung ventilation with positive end-expiratory pressure (PEEP) of 10–12cm H2O, positive changes on US were noted as soon as at 7–12 hours after the treatment initiation. The US showed hyperechogenic sites against the hypoechogenic structure of the affected lung which indicated the presence of air in the large bronchi. Further observation showed that the area of hypoechogenic structure in the airless lung was decreasing. In one patient the US examination on day 7 showed emerging non-echogenic homogenous sites of 3×2cm (haematoma). In the cases of lung contusion without therapy, we observed a slightly intensified vascular pattern with vessels extended in diameter. Conclusions: US examinations performed over time allows to investigate the lung structure within the treatment of patients with BTT.