Phải mặt thoát vị cơ hoành bẩm sinh. (A) X-quang ngực trán ở trẻ sơ sinh suy hô hấp và độ mờ đục ngực dưới bên phải của nguyên nhân không rõ ràng. (B) dọc siêu âm qua ngực phải kém cho thấy một khiếm khuyết (mũi tên) trong hemidiaphragm quyền cơ bắp (đầu mũi tên) với thoát vị nội dung bụng vào ngực (C). | 414 cơLEy Fig. 18. Right-sided congenital diaphragmatic hernia. A Frontal chest radiograph in an infant with respiratory distress and right lower chest opacity of unclear etiology. B Sagittal sonogram through the inferior right chest shows a defect arrow in the muscular right hemidiaphragm arrowheads with herniation of abdominal contents into the chest C . can be useful in determining an efficacious treatment 55 56 . Common benign chest wall masses include vascular malformations lymphangiomas lipomas and lymph nodes. Hemangiomas and other vascular lesions usually have discoloration of the overlying skin providing the first clue to diagnosis. On gray-scale imaging hemangiomas are variably echogenic depending on the amount of fatty stroma and are typically well circumscribed. Hemangiomas usually have high Doppler frequency shifts and high color Doppler vessel density whereas other vascular malformations do not 55 . Lymphangiomas have variably sized cystic components whose echogenicity depends on whether there has been infection or hemorrhage into the normally anechoic cyst fluid. They may be found anywhere in the chest but are most common in the axilla. Extension and infiltration into the mediastinum is common and may necessitate other imaging such as MR imaging for complete evaluation. Treatment may be surgical excision although less invasive percutaneous sclerotherapy shows great promise. Lipomas are generally well-circumscribed masses usually located within the subcutaneous tissues typically echogenic because of their fat content 39 . Color Doppler flow to lipomas is minimal. Lymph nodes are usually recognizable by their echogenic fatty hila containing the central nodal blood supply although inflamed and infiltrated nodes may have distorted internal architecture and color Doppler flow. Firm nontender masses may be secondary to bony or cartilaginous anomalies 13 57 . Bony ab normalities are often detectable by radiography but US can clarify and confirm findings. .
