الفهرس 
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Abstract
Study Objectives: To disclose the efficacy of transthoracic ultrasonography as method for radiological diagnosis of peripheral pulmonary and solid pleural lesions based on describing ultrasonographic features of the lesions and also as a supporting aid in transthoracic ultrasound guided biopsy. Patients and methods: Prospective clinical study was conducted on 122 patients presented with peripheral pulmonary and pleural lesions by chest x-ray. They underwent echopulmonography and CT chest evaluation. Patients were divided into two groups: Group (1), 63 patients diagnosed by CT chest and CT guided biopsy followed by EPG. Group (2), 59 patients diagnosed by EPG and ultrasound (US) guided biopsy followed by CT chest. Tissue biopsy was taken either through CT guided biopsy or ultrasound guided biopsy for pathological examination.
Results: EPG had success rate 75.9% in diagnosing malignancy and 17.2% in diagnosing nonmalignant lesions. Success rate of EPG based diagnosis in all studied cases was 45%. Using EPG criteria; rounded and oval morphology were statistically significantly higher in malignant than nonmalignant subgroups (53.4% versus 32.8%) in contrast to irregular morphology with ramifications that prevailed in nonmalignant subgroup (67.2% versus 46.5%). Irregular pleural contour and heterogeneous hypoechogenecity were predominant in nonmalignant subgroup (67.1%& 28.1% respectively). Echoinvasion,destruction of normal tissue architecture and blood vessels displacement were more common in malignant than nonmalignant subgroups.
Conclusion: Echopulmonography has a worthy role in differentiating benign from malignant peripheral pulmonary and pleural lesions. US guided biopsy is performed with a low risk of complications.