Egyptian Journal of Chest Disease and Tuberculosis (Jul 2016)
Diagnostic performance of trans-thoracic sonography in patients of pneumonia and pulmonary embolism
Abstract
Background: Trans-thoracic ultrasonography (TUS) has attracted great interest in the last few years in the diagnosis of some chest diseases that have a high mortality rate. Objective: This study was conducted to determine the diagnostic accuracy of TUS in patients with pneumonia and pulmonary embolism. In addition, the sonomorphological changes in both diseases were studied. Patients and methods: The study population comprised of 17 cases of pneumonia (10 males and 7 females) with a mean age of 52.02 years and 14 cases of pulmonary embolism (9 males and 5 females) with a mean age of 43.4 years. Diagnosis was based on the standard guidelines. Chest X-rays, arterial blood gases, CT chest and TUS were performed. Lung profile and other sonographic abnormalities were assessed by TUS. Results: The sensitivities, specificities and diagnostic accuracies of TUS based on lung profile vs. CT findings were 88.2%, 87.5% and 93.5% for pneumonia, 71.4%, 80.9% and 87.1% for pulmonary embolism, respectively. Chest X-ray was diagnostic for pneumonia in 11/17 cases (sensitivity 64.7%) whereas TUS was positive in 14/17 (sensitivity 82.4%) with a significant higher area under the curve for TUS vs. chest X-ray (0.84 vs. 0.70, P = 0.02). 82% and 64.3% of patients with pneumonia and pulmonary embolism, respectively had abnormal parenchymal lesions with most of these lesions showing no significant difference in the two disease entities. Conclusions: Lung profiles that can be detected using TUS can perform well to some extent as a rapid diagnostic technique among patients with pneumonia and pulmonary embolism. TUS seems to be superior to chest X-ray in the diagnosis of pneumonia. However, TUS failed to discriminate between pneumonia and pulmonary embolism on studying their parenchymal lesions.
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