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Ultraschall Med 2021; 42(06): 576-578
DOI: 10.1055/a-1652-7805
Editorial

Ultrasound, the handyman serving our whole populations in the post COVID-19 pandemic

Ultraschall, der Handwerker im Dienste der gesamten Bevölkerung nach der COVID-19-Pandemie
Fabio Piscaglia
1   Alma Mater Studiorum, University of Bologna, Italy
,
Bernardo Stefanini
2   Division of Internal Medicina, Hepatobility and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
,
Vito Cantisani
3   Ultrasound Unit, Policlinico Umberto I, University La Sapienza, Rome, Italy
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Since the introduction of the B-mode technology around 40 years ago the evolution of ultrasonography has been greatest and has surpassed the evolution of other imaging methods such as Computed Tomography or Magnetic Resonance from some points of view. Ultrasound now spans through an extremely wide range of regular uses, covering needs of the entire spectrum of our citizens. The articles published in this issue of the journal are a very illustrative example of such versatility. For instance, if we consider the ages of the population, these articles show how ultrasound is regularly utilized with great benefit at any time of the human life. Its use spans from the very early times, like the prenatal intrauterine conditions [1], moving to the perinatal period [2], the adult life [3] [4], times at which CT or MRI are scantly of any use and finally to the disease of the elderly, such as Alzheimer’s dementia [5]. Not only applications of ultrasonography cover the entire spectrum of human life in terms of time, but the size and price of the scanners range from relatively large top level scanners movable only on wheels, where the newest advanced technologies can be implemented [3] and valued over 100 000 Euros, to pocket size scanners, which are conveniently utilized at the bedside [6] and easily held in one hand. The very recent technologies have even added the possibility to connect battery operated ultrasound transducers to some potent commercial smartphones in the setting of hand-held ultrasonography. This technology skips the need of dedicated scanners and may keep low the entry prices, making the ratio between the most expensive and the cheapest ultrasonography tools potentially larger than 100 times. Similar ranges of scanners size, capabilities and costs are not present for CT or MR. Furthermore, ultrasound has become capable not only to display morphological information, but also functional findings: for instance presence and velocity of blood flow in large vessels with Doppler, tissue stiffness with elastography [7], tissue perfusion with quantification of contrast ultrasound [8] and very recently measurement of tissue ultrasound dispersione/viscosity or quantification of liver fat content [3] [9] [10] [11] are almost all become potentially available in the same equipment. Beside the extension in terms of life time and types of equipments, the COVID-19 pandemic has made a reality also a larger use of ultrasound in body districts and enviromental settings. Ultrasound was known to be able to accurately investigate extremely superficial structures such as the skin with super high frequency tranducers as well as deep body regions like the heart or retroperitoneal vessels. However the use of ultrasound for pulmonary investigations was claimed to be effective, but often limited to intensive care units, not having still achieved widespread use. The need to assess Sars-Cov-2 infected patients, who often suffer primarily from a pulmonary involvement and for which there was, and still there is a need to restrict the access to hospital only to those in clear need to avoid an overwhelming of health care facilities, has put ultrasound on the stage. Lung ultrasound has in fact rapidly become part of the assessment of such patients, gaining large success [12] [13] [14]. It is relatively easy to learn, making physicians more confident in the decision to keep patients at home or to refer them to hospital and has become seamlessly integrated in the clinical sonographic assessment of such patients. In this issue of the journal the potential of lung ultrasound is mentioned [15]. However, we would like to draw the attention to the integration of ultrasound into the clinical assessment of patients, when utilized by physicians who are not only those performing ultrasound, but also those primarily in charge of the clinical decisions. This is the emerging concept of point-of-care ultrasound or even better of the ultrasound assisted visit of our patients, where ultrasound is utilized as an extremely valuable extension of the physicial examination, enabling doctors to take more consistent decision about the planning of the best diagnostic and therapeutical strategies for our patients. This has been defined as the Sonography-Assisted Medical Examination (SAME) [16] [17]. An example of this concept is illustrated also in an article of the present issue [4]. Therefore also from this point of view ultrasound is showing the widest range of applications in terms of organs regularly investigated to the setting of use, spanning from top radiology enviroments with Multiparametric ultrasound, to clinical wards, to the emergency department and intensive care units to territorial services, ambulances and increasingly also the home of patients.

Altogether, after the COVID pandemic ultrasound appears to have become even more openly the medical act at the greatest service of our populations.



Publication History

Article published online:
02 December 2021

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