Abstract
Background: Chest X-ray (CXR) is the primary diagnostic tool for community-acquired pneumonia (CAP). Some authors recently proposed that thoracic ultrasound (TUS) could valuably flank or even reliably substitute CXR in the diagnosis and follow-up of CAP. We investigated the clinical utility of TUS in a large sample of patients with CAP, to challenge the hypothesis that it may be a substitute for CXR. Methods: Out of 645 consecutive patients with a CXR-confirmed CAP diagnosed in the emergency room of our hospital over a three-years period, 510 were subsequently admitted to our department of Internal Medicine. These patients were evaluated by TUS by a well-trained operator who was blinded of the initial diagnosis. TUS scans were performed both at admission and repeated at day 4-6th and 9-14th during stay. Results: TUS identified 375/510 (73.5%) of CXR-confirmed lesions, mostly located in posterior-basal or mid-thoracic areas of the lungs. Pleural effusion was detected in 26.9% of patients by CXR and in 30.4% by TUS. TUS documented the change in size of the consolidated areas as follows: 6.3 ± 3.4 cm at time 0, 2.5 ± 1.8 at 4-6 d, 0.9 ± 1.4 at 9-14 d. Out of the 12 patients with delayed CAP healing, 7 of them turned out to have lung cancer. Conclusions: TUS allowed to detect lung consolidations in over 70% of patients with CXR-confirmed CAP, but it gave false negative results in 26.5% of cases. Our longitudinal results confirm the role of TUS in the follow-up of detectable lesions. Thus, TUS should be regarded as a complementary and monitoring tool in pneumonia, instead of a primary imaging modality.
| Original language | English |
|---|---|
| Article number | 52 |
| Journal | BMC Medical Imaging |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Aug 31 2017 |
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Keywords
- Community acquired pneumonia (CAP)
- Complementary diagnostic tool
- Follow-up
- Thoracic ultrasound (TUS)
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap). / D'Amato, Maria; Rea, Gaetano; Carnevale, Vincenzo; Grimaldi, Maria Arcangela; Saponara, Anna Rita; Rosenthal, Eric; Maggi, Michele Maria; Dimitri, Lucia; Sperandeo, Marco.
In: BMC Medical Imaging, Vol. 17, No. 1, 52, 31.08.2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap)
AU - D'Amato, Maria
AU - Rea, Gaetano
AU - Carnevale, Vincenzo
AU - Grimaldi, Maria Arcangela
AU - Saponara, Anna Rita
AU - Rosenthal, Eric
AU - Maggi, Michele Maria
AU - Dimitri, Lucia
AU - Sperandeo, Marco
PY - 2017/8/31
Y1 - 2017/8/31
N2 - Background: Chest X-ray (CXR) is the primary diagnostic tool for community-acquired pneumonia (CAP). Some authors recently proposed that thoracic ultrasound (TUS) could valuably flank or even reliably substitute CXR in the diagnosis and follow-up of CAP. We investigated the clinical utility of TUS in a large sample of patients with CAP, to challenge the hypothesis that it may be a substitute for CXR. Methods: Out of 645 consecutive patients with a CXR-confirmed CAP diagnosed in the emergency room of our hospital over a three-years period, 510 were subsequently admitted to our department of Internal Medicine. These patients were evaluated by TUS by a well-trained operator who was blinded of the initial diagnosis. TUS scans were performed both at admission and repeated at day 4-6th and 9-14th during stay. Results: TUS identified 375/510 (73.5%) of CXR-confirmed lesions, mostly located in posterior-basal or mid-thoracic areas of the lungs. Pleural effusion was detected in 26.9% of patients by CXR and in 30.4% by TUS. TUS documented the change in size of the consolidated areas as follows: 6.3 ± 3.4 cm at time 0, 2.5 ± 1.8 at 4-6 d, 0.9 ± 1.4 at 9-14 d. Out of the 12 patients with delayed CAP healing, 7 of them turned out to have lung cancer. Conclusions: TUS allowed to detect lung consolidations in over 70% of patients with CXR-confirmed CAP, but it gave false negative results in 26.5% of cases. Our longitudinal results confirm the role of TUS in the follow-up of detectable lesions. Thus, TUS should be regarded as a complementary and monitoring tool in pneumonia, instead of a primary imaging modality.
AB - Background: Chest X-ray (CXR) is the primary diagnostic tool for community-acquired pneumonia (CAP). Some authors recently proposed that thoracic ultrasound (TUS) could valuably flank or even reliably substitute CXR in the diagnosis and follow-up of CAP. We investigated the clinical utility of TUS in a large sample of patients with CAP, to challenge the hypothesis that it may be a substitute for CXR. Methods: Out of 645 consecutive patients with a CXR-confirmed CAP diagnosed in the emergency room of our hospital over a three-years period, 510 were subsequently admitted to our department of Internal Medicine. These patients were evaluated by TUS by a well-trained operator who was blinded of the initial diagnosis. TUS scans were performed both at admission and repeated at day 4-6th and 9-14th during stay. Results: TUS identified 375/510 (73.5%) of CXR-confirmed lesions, mostly located in posterior-basal or mid-thoracic areas of the lungs. Pleural effusion was detected in 26.9% of patients by CXR and in 30.4% by TUS. TUS documented the change in size of the consolidated areas as follows: 6.3 ± 3.4 cm at time 0, 2.5 ± 1.8 at 4-6 d, 0.9 ± 1.4 at 9-14 d. Out of the 12 patients with delayed CAP healing, 7 of them turned out to have lung cancer. Conclusions: TUS allowed to detect lung consolidations in over 70% of patients with CXR-confirmed CAP, but it gave false negative results in 26.5% of cases. Our longitudinal results confirm the role of TUS in the follow-up of detectable lesions. Thus, TUS should be regarded as a complementary and monitoring tool in pneumonia, instead of a primary imaging modality.
KW - Community acquired pneumonia (CAP)
KW - Complementary diagnostic tool
KW - Follow-up
KW - Thoracic ultrasound (TUS)
UR - http://www.scopus.com/inward/record.url?scp=85028564204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028564204&partnerID=8YFLogxK
U2 - 10.1186/s12880-017-0225-5
DO - 10.1186/s12880-017-0225-5
M3 - Article
AN - SCOPUS:85028564204
VL - 17
JO - BMC Medical Imaging
JF - BMC Medical Imaging
SN - 1471-2342
IS - 1
M1 - 52
ER -