Role of ultrasonography in the diagnosis of pleural effusion

Abstract

Abstract Background Transthoracic ultrasonography (TUS) represents a useful diagnostic tool in the management of pleural diseases. It is the best method for guiding interventional procedures in the pleural space. Objectives The aim of this study was to detect the role of ultrasonography (US) in the diagnosis and management of pleural effusion in comparison with computed tomography (CT). Patients and methods Patients with suspected clinical and radiological evidence of pleural effusion were included. Routine laboratory investigations, chest radiography, CT of the chest, TUS, and thoracentesis with biochemical, bacteriological, and cytological examination of pleural fluid were carried out for all patients, and medical thoracoscopy and US-assisted interventions were carried out whenever needed. Results Eighty-four patients were included in the study. Male patients represented 56% (47 cases), whereas female patients constituted 44% (37 cases); their mean age was 51.21±14.1 years (range: 14–80 years). Seventy-three (86.9%) cases had exudative effusions; inflammatory causes (n=33) and malignancy (n=31) were the most common. TUS was equal to CT in the detection of pleural effusion, pleural thickening, hydropneumothorax, pleural nodule, and consolidation. Moreover, US was better than chest radiography in the detection of pleural thickening, encysted pleural effusion, pleural mass, and consolidation. US was better than CT in the detection of septations (n=30 vs. 5). However, CT was better than US in the detection of loculation (n=28 vs. 17) and pulmonary mass (n=8 vs. 4). Thorcoscopy was performed for nine patients, and was better than US and CT in the detection of pleural nodules. Conclusion TUS is an efficient, quick, inexpensive, radiationfree method for the evaluation of pleural diseases.

Keywords

• conventional computed tomography of the chest
• pleural effusion
• transthoracic ultrasonography