Results: In 51 cases intraoperative imaging was the main reason forinvestigation and in 15 cases neuronavigation was in the focus ofinterest. In 20 cases of tumor resection control, targeting a visualizedremnant was necessary. ENS proved in this small series to makeneuroendoscopy safer and easier by online and real-time imaging withhigh resolution. There are limitations and artifacts, which should revealthemselves in laboratory and clinical experience.Conclusions: Endo-neuro-sonography, as it stands now, is a techniquethat can contribute to the concept of minimally invasive techniques inneurosurgery, as this presentation does describe.

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Sonographically guided fine-needle aspiration biopsy of multiplethyroid nodulesKim J, Bae IH, Chungbuk National University Hospital, Korea

Objectives: The purpose of this study is the evaluation of pathologicresult in a patient who had multiple nodules, and to decrease unneces-sary procedure or operation.Methods: We conducted a prospective study in 545 nodules of 205patients (mean age 48 years; range 20 to 78) who had two or morenodules between February 2002 and March 2004. All nodules werepathologically proven by USG-guided percutaneous fine-needle aspi-ration biopsy or surgery were included in this study. Compare thepathologic result of each nodule in a patient according to the internalcontent, margin, echogenicity, shape and calcification. We classified astwo groups, all nodules’ feature was same group and at least onenodule’s feature was different group.Results: In 205 patients, 78 were equal featured group and 127 werenot. Equal featured group’s pathologic result is same in all patients(100%). Different featured group’s pathologic results were different in23(18%) patients and same in 104 (82%).Conclusions: If the feature of multiple nodules is equal, then thepathologic result is same in a patient. So, when doing FNAB samefeatured multiple nodules, only one representative nodule can be aspi-rated.

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The role of ultrasonography in the diagnosis of blunt andpenetrating thoracic traumaTrofimova EY, Abakumov MM, Kartavenko VI, Gusev VV,N.V.Sklifosovsky Research Institute of Emergency Medical Aid,Russian Federation

Objectives: To study the potential of ultrasonography (US) for lungmonitoring in patients with thoracic trauma.Methods: We reviewed the results of serial thoracic US examinationsperformed in 320 patients admitted with lung injury after severe bluntthoracic trauma (BTT) (225) and penetrating wounds (PW) (95).Results: In 37 patients (11.6%), US performed within the first 24 h waslow informative because of subcutaneous emphysema. The US sensi-tivity in identifying hemothorax within the first several hours aftertrauma was 92%. Further US examinations revealed hemothorax innine more patients, aggravation of hemothorax in three, clotted hemo-thorax in 12, pleural empyema in 10 patients. Lung abnormalities wererevealed in 76 patients (80%) after PW. In eight patients with thewound in the lung edge, no abnormalities were visualized. Within thefirst 48 hours after BTT, lung trauma was revealed in 42 patients(18.7%). Later on, US showed intrapulmonary hematoma in six pa-tients and intrapulmonary abscess in one patient. The treatment of 35patients with BTT and US-revealed lung contusion included mechan-ical lung ventilation (PEEP). US monitoring demonstrated markedimprovement over time.

Conclusions: US may be used as a monitoring technique to evaluatepleural cavity and lung helping to reduce X-ray exposure.

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The usefulness of ultrasound guided core needle biopsy inperipheral pulmonary diseasesQi Q, Zhang H, Ji Z, Huang B, Mao F, Wang W, ZhongshanHospital, Fudan University, Shanghai, China

Objectives: To evaluate the efficacy of ultrasound-guided core needlebiopsy (US-CNB) with 16-gauge cutting needle in the diagnosis ofperipheral pulmonary diseases.Methods: One hundred twenty-four patients with peripheral pulmo-nary diseases underwent US-CNB. Among them, 112 patients hadundergone thoracoscope examination and failed to get a histologicdiagnosis. Biopsy was performed with US guidance by a free handtechnique using 3.5 MHz transducer and an automatic spring loadedbiopsy gun with a 16-gauge cutting needle for lesions larger than 20mm or a 16-gauge semiautomatic biopsy needle for lesions smaller than20 mm.Results: The histologic diagnoses were conclusive in 119 cases(96.8%) and inconclusive in five cases (3.2%).The histologic diagnosesincluded 64 cases of benign diseases and 55 cases of malignancy. Therewere nine cases of complications: hemoptysis (n � 5), pneumothorax(n � 2) and pain (n � 2). None was severe.Conclusions: US-CNB with 16-gauge cutting needle in the diagnosisof peripheral pulmonary disease is safe and has high accuracy. It is aneffective complementary method of thoracoscope.

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Ultrasound-guided interventional procedures in pleural diseases:State of the artKang E-Y, Woo OH, Yong H-S, Oh Y-W, Park C-M, Cha I-H,College of Medicine, Korea University, Korea

This exhibit is to illustrate the usefulness of ultrasound-guided inter-ventional procedures in patients with pleural diseases. In clinical prac-tice, pleural diseases are very common and thoracic radiologists play acrucial role in the imaging and management of pleural diseases. Tho-racic radiologists use US frequently for diagnostic and therapeuticthoracentesis, drain catheter insertions, and pleural biopsies. A 3.5–10MHz sector or linear transducer is used according to requirement ofspatial resolution and penetration depth, and US window for pleura isintercostal spaces. US assess the presence of pleural disease and eval-uate pleural effusion with septa and loculations. Diagnostic and ther-apeutic thoracentesis is required for pleural effusions and US-guidedthoracentesis improves the success and decreases complications. Im-age-guided pleural biopsy shows a high diagnostic yield. US-guideddrainage catheter insertion is very convenient for patients with com-plicated pleural effusion. US is the modality of choice for the inter-ventional procedures in patients with pleural diseases.

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Classification of pleural effusions proposed by sonographyNeto M, Cirino LM, Funari M, Daniel M, Francisco L, Cerri G,Chammas MC, Hospital das Clinicas da Faculdade Medicina-USP,Brazil

This study discusses the utility of the ultrasound in the classification ofthe pleural effusion and proposes a classification for them. Fifty-fivepatients from our institution, with pleural effusion proved by thoracen-tesis, were prospectively studied. The authors propose a classificationdivided in seven types of pleural effusion, based on echogenicity of thefluid, pleural and pulmonary parenchyma alterations. It is concluded

Abstracts P247