Gain value (G)
9/19
Contrast value (C)
4/8
Image quality (I)
Image-1
Scanning direction (DIR)
Inverse (INV)
Fig. 16.1
Setting of the ultrasound device
16.2 Typical R-EBUS Findings [3–8]
R-EBUS is a device to confirm the location of a lesion, but this would be difficult if the typical findings are not known. Basically, a solid lesion is visualized as a heterogeneous gray signal, but some air-filled lesions show high-intensity echoes scattered on the inside. GGO presents with blizzard sign, which is an enhancement of high-intensity signals, or mixed blizzard sign, which shows high-intensity signals scattered inside a heterogeneous signal. It is sometimes difficult to distinguish between a blood vessel and a pulmonary parenchymal lesion because the device is not equipped with a Doppler mode. Nevertheless, blood vessels are usually visualized as hypoechoic signals, not heterogeneous. The followings are the most commonly encountered R-EBUS findings:
Get Clinical Tree app for offline access
- 1.
R-EBUS scanning of a peripheral pulmonary lesion using an ultrasound probe that is functioning properly (Fig. 16.2).
Fig. 16.2
Typical R-EBUS scanning of a peripheral pulmonary lesion shows a heterogeneous circumferential signal around the probe
- 2.
R-EBUS scanning of a peripheral pulmonary lesion when an ultrasound probe is filled with air bubbles (Fig. 16.3). The absence of signals may give the impression that the ultrasound probe is damaged. In such case, let the air bubbles come out by holding the probe at 5 cm from its tip and shaking it gently while facing downward.
Fig. 16.3
R-EBUS scanning of a peripheral pulmonary lesion shows no signal around the probe. In this case, the probe is filled with bubbles
- 3.
Blood vessels have hypoechoic signals on R-EBUS (Fig. 16.4). Confirm by moving the ultrasound probe back and forth.
