Ultrasound guided puncture of pleural fluid collections and superficial thoracic masses.

Fluoroscopically guided percutaneous aspiration biopsy of pulmonary masses and conventional needle thoracocentesis for the diagnostic evaluation and treatment of pleural fluid collections, are well established procedures. In the abdomen, ultrasonographic guidance is a widely accepted method, but is usually considered to be of limited values in the chest because of overlying ribs and aerated lung tissue. Nevertheless, ultrasound is well suited as a guiding modality for both aspiration of pleural fluid collections and biopsy of pleural thoracic masses. We describe and discuss the method on the basis of 55 punctures in 46 patients, in most of whom previous attempts guided by radiography and clinical examination had failed. Diagnostic/therapeutic results were obtained in all cases but one. The only complication was minor pneumothorax in two patients.