Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap)
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...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-08-01
|
| Series: | BMC Medical Imaging |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12880-017-0225-5 |
| _version_ | 1819077671314784256 |
|---|---|
| author | Maria D’Amato Gaetano Rea Vincenzo Carnevale Maria Arcangela Grimaldi Anna Rita Saponara Eric Rosenthal Michele Maria Maggi Lucia Dimitri Marco Sperandeo |
| author_facet | Maria D’Amato Gaetano Rea Vincenzo Carnevale Maria Arcangela Grimaldi Anna Rita Saponara Eric Rosenthal Michele Maria Maggi Lucia Dimitri Marco Sperandeo |
| author_sort | Maria D’Amato |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T19:00:54Z |
| format | Article |
| id | doaj.art-914775c3660a4e0aac21053838608aaf |
| institution | Directory Open Access Journal |
| issn | 1471-2342 |
| language | English |
| last_indexed | 2024-12-21T19:00:54Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Imaging |
| spelling | doaj.art-914775c3660a4e0aac21053838608aaf2022-12-21T18:53:30ZengBMCBMC Medical Imaging1471-23422017-08-011711810.1186/s12880-017-0225-5Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap)Maria D’Amato0Gaetano Rea1Vincenzo Carnevale2Maria Arcangela Grimaldi3Anna Rita Saponara4Eric Rosenthal5Michele Maria Maggi6Lucia Dimitri7Marco Sperandeo8Department of Pneumology, “Federico II University”, AO “Dei Colli” Monaldi HospitalDepartment of Radiology, AO “Dei Colli” Monaldi HospitalUnit of Internal Medicine, “Casa Sollievo della Sofferenza” Hospital, IRCCSUnit of Internal Medicine and Pneumology, “Casa Sollievo della Sofferenza” Hospital, IRCCSUnit of Internal Medicine, Local Health ServiceDepartment of Internal Medicine, Hospital Archet 1Unit of Emergency Medicine, “Casa Sollievo della Sofferenza” Hospital, IRCCSUnit of Pathology, “Casa Sollievo della Sofferenza” Hospital, IRCCSUnit of Interventional and Diagnostic Ultrasound of Internal Medicine, “Casa Sollievo della Sofferenza” Hospital, IRCCSAbstract 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.http://link.springer.com/article/10.1186/s12880-017-0225-5Community acquired pneumonia (CAP)Thoracic ultrasound (TUS)Complementary diagnostic toolFollow-up |
| spellingShingle | Maria D’Amato Gaetano Rea Vincenzo Carnevale Maria Arcangela Grimaldi Anna Rita Saponara Eric Rosenthal Michele Maria Maggi Lucia Dimitri Marco Sperandeo Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) BMC Medical Imaging Community acquired pneumonia (CAP) Thoracic ultrasound (TUS) Complementary diagnostic tool Follow-up |
| title | Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) |
| title_full | Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) |
| title_fullStr | Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) |
| title_full_unstemmed | Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) |
| title_short | Assessment of thoracic ultrasound in complementary diagnosis and in follow up of community-acquired pneumonia (cap) |
| title_sort | assessment of thoracic ultrasound in complementary diagnosis and in follow up of community acquired pneumonia cap |
| topic | Community acquired pneumonia (CAP) Thoracic ultrasound (TUS) Complementary diagnostic tool Follow-up |
| url | http://link.springer.com/article/10.1186/s12880-017-0225-5 |
| work_keys_str_mv | AT mariadamato assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT gaetanorea assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT vincenzocarnevale assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT mariaarcangelagrimaldi assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT annaritasaponara assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT ericrosenthal assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT michelemariamaggi assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT luciadimitri assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap AT marcosperandeo assessmentofthoracicultrasoundincomplementarydiagnosisandinfollowupofcommunityacquiredpneumoniacap |