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(a) Chest X-ray showed no remarkable findings in patient with suspected pneumonia. (b) Longitudinal US image at upper half of the lateral area of Rt lung showed homogenous area of consolidation containing air bronchogram.
Source publication
Detection of a technique used for diagnosis of Community Acquired Pneumonia by chest ultrasound compared to chest radiograph.
Study
Sixty two patients presented with clinically diagnosed pneumonia (acute presentation of fever, cough, purulent expectoration and typical auscultation as rales and bronchial breath sound), patients with chronic chest a...
Citations
... Consequently, the diagnosis is predicated on history taking, physical examination, and identification of clinical features such as fever, cough, and breathlessness. [10][11][12] Confirmation of severe or complicated pneumonia is usually by identification of new infiltrates on CXR. [1,10] However, ionizing radiation coming from CXR may expose children to an increased risk of mutation of their genes and development of cancer later in life, because their tissues are relatively more radiosensitive. ...
Background
Pneumonia is an acute inflammatory condition affecting the lung alveoli. The current gold standard for diagnosis pneumonia in children is chest radiography (CXR). Lung ultrasound scan (LUS) may be used as a safer diagnostic alternative since it does not use ionizing radiation.
Aim
The study is to evaluate the diagnostic value of LUS compared with CXR among children with pneumonia.
Materials and Methods
It was a prospective cross-sectional study among 100 patients aged between 0 and 5 years, diagnosed with pneumonia. The spectrums of LUS findings were compared with chest radiographic findings of the same patients to ascertain the diagnostic value LUS. The LUS was performed using a 3.5–5.0 MHz convex probe and a high-frequency (7.5–10.0 MHz) linear transducer fitted to a Logic PRO 6.0, general electric ultrasound machine.
Results
The mean age of the participants was 17.6 (±12.4) months with males and females accounting for 60% and 40%, respectively. CXR and LUS detected pneumonia in 78% and 93% of patients respectively ( P = 0.002). In LUS, the most common findings were subpleural consolidation (73.0%), and pleural-line distortions (66%), while the commonest CXR findings were interstitial opacities (69%), and homogeneous consolidations (37%). The sensitivity and specificity of LUS in this study are 96.2% and 18.2%, respectively, with positive and negative predictive values of 80.6% and 57.1%, respectively.
Conclusion
LUS had a higher positive detection rate than CXR. Its high sensitivity, lack of ionizing radiation, and portability make it a useful first-line imaging modality in the diagnosis and manage pneumonia.
... According to Alkhayat and Alam-Eldeen [22], airbronchograms were detected in 87% of cases, whereas pleural effusions were present in 54%. This disparity may be related to the current study's selection of patients with no clinical data suggesting pneumonia even early. ...
... 35, No.1 (2022) alveolar syndromes with significance (P<0.04). This agrees with several studies, Amatya et al. (2018) and Alkhayat & Alam-Eldeen (2014), found that LUS demonstrated higher sensitivity for diagnosing pneumonia than chest X-rays. Ye et al. (2015), found in their systematic review and meta-analysis, that the performance of LUS for the detection of adult communityacquired pneumonia was excellent, as compared to the "gold standard" (CT chest scan). ...
... It has been demonstrated that diaphragmatic ultrasonography is a non-invasive, readily conducted, quickly taught, and reliable method for measuring diaphragmatic function. It is a straightforward application of echography that is speedy, portable, reproducible, and nonionizing, which is particularly essential in newborns who have a higher risk of cancer from exposure to radiation than persons of other ages [5]. ...
Background: Bronchiolitis is an acute viral respiratory illness that affects children younger than 24 months of age, with severe disease more common among infants from 1–3 months. The aim of the research was to investigate the correlation between diaphragmatic ultrasound parameters, with clinical scoring of acute bronchiolitis to evaluate their role in assessment of disease severity and to evaluate diaphragmatic ultrasound findings in patients with acute bronchiolitis. Methods: This research was carried out on sixty infants aged from (one month to 2 years) at 1st attack of wheezy chest. According to clinical scoring cases were divided in to three groups: group (1): mild bronchiolitis with clinical scoring from (1-3) including 30 patients, group (2): Moderate bronchiolitis with clinical scoring (4-7) including 20 patient, and group (3): severe bronchiolitis with clinical scoring from (8-14) including 10 patients. All infants were subjected to chest X-ray, laboratory methods (Complete blood count and C-reactive protein), and clinical Scoring. Results: There was a significant positive correlation between diaphragmatic excursion and length of hospital admission (r 0.395, p<0.00), a positive significant correlation between inspiratory slope and length of hospital admission. (r 0.439, p<0.001). Conclusions: Lung ultrasonography may play a role in the evaluation and workup of babies with bronchiolitis in the emergency room, helping doctors identify infants who may require more intensive treatment. Ultrasound of the diaphragm appears to be an objective and valuable technique for assisting the clinician in evaluating and treating bronchiolitis.
... 13 LUS has also been suggested as superior to a computed tomogram (CT), of the chest, for the diagnosis of CAP. 14 Some have proposed that LUS is beneficial and superior to CXR for the diagnosis of CAP. Besides the availability, fast access, and performance duration, as well as less radiation exposure, it is a valuable diagnostic tool 15 that could soon replace the CXR. 16 However, a meta-analysis of studies has cast doubt on the quality of the studies and has suggested LUS as an additional and adjuvant diagnostic tool. ...
... These results would suggest that LUS could not be suggested as an appropriate alternative for CXR in the diagnosis of CAP, which seems to be in contrast with most of the previous studies in this regard, reporting a high diagnostic accuracy for LUS in patients suspected of CAP. 10,11,13,15,23 Some studies have focused on the pediatric population, 11,12,24 which were not reviewed, as the diagnostic approach of pediatric CAP is different from that of adults, 3,25 which was the target population of this study. Other studies have also reported a higher diagnostic accuracy for LUS in the diagnosis of pneumonia, in general, 17,23,26-28 which were not discuss here, as we only focused on the diagnosis of CAP. ...
... Some others have also included other diagnostic methods, like CT, in their study. In a study on 62 patients suspected of CAP according to clinical signs and symptoms, LUS showed higher diagnostic accuracy for diagnosis of CAP-related consolidation than CXR (74.2% vs 51.6%, respectively), 15 which is contrary to the results of this study. In the study by Reissig and colleagues, investigating 262 patients suspected of CAP with LUS showed a sensitivity of 93.4% and specificity of 97.7%, compared with the reference test, a two-plane radiograph, or CT scan in cases with a negative radiograph, but positive LUS results. ...
Objective
Community-acquired pneumonia (CAP) is a common respiratory infection, and diagnosis is frequently performed using a chest radiography (CXR). Sonography is an available method with less radiation exposure, but has not been confirmed for diagnosis of CAP. The objective was to compare the diagnostic accuracy of sonography.
Materials and Methods
In this cross-sectional study, 90 adult patients (aged >18 years) were admitted to the emergency department of two university-affiliated hospitals in Southwest Iran, from July to December 2019, with a confirmed diagnosis of CAP. The patient symptoms and CXR results were included as part of this study. Within 24 hours after obtaining a CXR, a lung ultrasonogram (LUS) was performed. The diagnostic accuracy of semiquantitative LUS (SQLUS) was compared with CXR results using the Pearson chi-square test and Fisher’s exact test.
Results
The mean age of participants was 52.98 ± 16.77 years. 51 were men (56.7%). 28 patients (31.1%), who had abnormal SQLUS results, were not associated with CXR findings ( P = .296). SQLUS showed poor diagnostic accuracy for LUS (31.11%).
Conclusion
This study results could not confirm LUS as an accurate method for diagnosing CAP in adult patients; although due to the convenient sample of adults and clinical-based diagnosis of CAP, any generalization of the results should be made with caution.
... However, on the other hand, Al-Khayat and Alam-Eldeen [9] conducted a study on 62 pneumonia patients and found that chest US was diagnostic in 46 (74%) patients. This difference in accuracy might be attributed to the fact that transthoracic US technique allows identification of areas of consolidation only when they are connected to the pleural surface. ...
Objective To evaluate the role of chest ultrasonography (US) in diagnosing the causes of acute respiratory failure (ARF). Background ARF is a common critical problem and can arise from many diseases. Several modalities such as chest radiograph, US, and computed tomography (CT) scan are being used to diagnose and detect the causes of ARF. Patients and methods The study included 50 patients with ARF admitted to the ICU of Menoufia University Hospital and ICU of Kafr El-Sheikh Chest Hospital. We compared between chest radiograph, chest US, and CT as diagnostic tools to detect the etiology of ARF. Results The sensitivity, specificity, positive predictive value, and negative predictive value and accuracy of lung US in the detection of chest disorders causing ARF were 93.7, 50, 97.8, 45, and 92%, respectively, compared with chest CT as a gold-standard Bedside Lung Ultrasonography in Emergency department protocol was used in the diagnosis of different causes of ARF. Lung US was free in 6% of patients, A profile was found in 12%, A’ profile was found in 2%, A’ profile with anechoic area or hypoechoic area in 6%, B profile was found in 12%, B’ profile in 12%, B’ profile with anechoic area or hypoechoic area in 32%, A/B profile in 6%, no color sign was found in 10%, and hypoechoic simple effusion in 2% of selected patients. Conclusion Chest US is a reliable, quick, bedside, low-cost, noninvasive, and nonionizing imaging tool for early detection of chest-disease causes of ARF.
... Chest ultrasound proved to be a sensitive and specific tool in diagnosis of CAP. Our study validates other studies (15,(18)(19)(20), where the panoramic view provided by the transducer image allowed overseeing large areas of the peripheral and sub-pleural lung areas. In our study, CT had the highest sensitivity and specificity in diagnosis of CAP and its complications. ...
Background: Pneumonia remains a major cause of morbidity and mortality in childhood with a higher burden in developing countries. Diagnosis relies on clinical findings with supporting evidence from chest X-ray (CXR) and occasionally chest computed tomography (CT).
Aim of the work: The aim of this study was to assess the role of lung ultrasonography (LUS) for bedside diagnosis of pediatric pneumonia in comparison to chest CT as a gold standard. Methods: The study was performed on 50 children admitted to Cairo University Children’s Hospitals. All children presented with the classical clinical picture of pneumonia and did CXR, LUS and chest CT.
Results: Radiological findings demonstrated lung consolidation in 48 patients (96%) by CXR, 49 (98%) patients by LUS and all 50 patients (100%) by CT chest. Pleural effusion was found in 8 (16%) patients by CT chest, all of which were detected by LUS (100%), but only 5 were correctly detected by CXR (specificity 62.5%) in addition to 3 false positive cases. LUS detected pleurisy in 29 children (58%) (specificity 100%) while X-rays did not. Also 70% of children needed sedation before CT scanning as compared to none for LUS.
Conclusion: Lung ultrasound is a sensitive, specific, safe and available tool that can be used by clinicians in cases of suspected pneumonia. It is more reliable than CXR, does not require sedation, and can be repeated at the patient's bedside with no risk of irradiation.
... In our study, visualization lung consolidation, hepatization, or alveolar interstitial syndromes with positive clinical findings was used to diagnose pneumonia. Corresponding to many studies (19)(20)(21) , our results confirmed that the use of LUS over CXR in diagnosis of pneumonia demonstrated higher specificity, sensitivity and DA. For cases admitted to ER with suspected CAP, LUS dependent diagnosis agreed with CT finding in nearly all the diagnosed cases especially at early pneumonia development (22,23) , an advantage that can elicit earlier therapeutic interventions. ...
... Chest ultrasound had sensitivity 95%. Moreover, the study conducted by Alkhayat and Alam-Eldeen [27] on 62 patients with clinically diagnosed pneumonia found that chest ultrasound had significant diagnostic value of consolidation.In our study, there was significant agreement between chest ultrasound and chest radiographic findings in all cases regarding cavitation and pneumothorax (100% agreement; all cases with cavitation and pneumothorax can be detected by both of them, with 100% sensitivity and 100% specificity). This was is agreement with the study conducted by Agmy et al. [28] on 96 patients, where eight of them had pneumothorax. ...
Context Chest ultrasound has a complementary role in patients with pulmonary tuberculosis (PTB). It can detect lesion especially in pleural and subpleural area.
Aim To assess chest ultrasound findings in patients with PTB with and without HIV.
Settings and design This was a prospective comparative cross-sectional study that was conducted in Abbassia Chest Hospital from November 2017 to November 2018.
Patients and methods The study was conducted on 50 new patients with PTB sputum positive by acid-fast bacilli or genexpert. They were classified into two groups: group I, with 25 HIV-negative patients, group II, with 25 HIV-positive patients. All patients underwent routine laboratory investigations, chest radiography, and chest and abdominal ultrasound.
Statistical analysis The analysis of comparison between the two groups regarding chest ultrasound findings was done using SPSS statistical package.
Results There was no significant difference between the two groups regarding chest ultrasound findings. The most frequent finding was subpleural nodules. It is present in all patients. Shred sign was present in 84% of both groups. Subpleural consolidation was present in all patients in group I and 88% of group II. Pleural effusion was present in 20% of group I and 28% of group II. Stratosphere sign and lung point were present in 8% of group II. Cavitation was present in 8% of group I. In both groups, A profile was present in 12%, B profile in 44%, and AB profile in 44%.
Conclusion There was no significant difference between patients with PTB with and without HIV regarding chest ultrasound findings. Chest ultrasound is a complementary tool in patients with TB with and without HIV.
... practice, particularly in emergency conditions [12,13]. Chest ultrasound allows prompt management based upon reproducible data and generates fewer computed tomography examinations, thereby decreasing irradiation, delays, cost, and discomfort to the patient [14]. ...
