Role of chest ultrasound in detecting successful pleurodesis

Abstract

Background: Thoracic ultrasonography easily detects the sign of ‘pleural sliding’, due to the movement of the visceral pleura on the parietal pleura. This sign is absent when pleurodesis is successful. Aim of work: This study was designed to detect the role of thoracic ultrasonography in the assessment of pleurodesis and compare between different sclerosing agents, mainly based on the presence or absence of the ‘pleural sliding’ sign. Subject and methods: The study was conducted in Kasr El-Aini hospital, Cairo University in the period from April 2014 to April 2015. It was carried on 30 patients, 15 males and 15 females. The patients included in the study were classified into 4 groups according to cause of pleurodesis as follow spontaneous pleurodesis by the intercostal chest tube (group 1), pleurodesis with bleomycin (group 2), pleurodesis with doxycyclin (group 3) and pleurodesis with betadine (group 4). All patients were subjected for complete history taking and clinical examination, chest X-rays, chest CT, and thoracic ultrasound study before and after pleurodesis with assessment of sliding sign. Results: The results of the study revealed that the ultrasound can easily detect sliding sign and assess the success of pleurodesis. Iodopovidone was more effective than bleomycin and doxycyclin in inducing pleurodesis in patients with malignant pleural effusion without statistically significant difference. Conclusions: Thoracic ultrasonography for the evaluation of pleurodesis is feasible and simple. Iodopovidone was more effective than bleomycin and doxycyclin in inducing pleurodesis in patients with malignant pleural effusion.

Keywords

• Thoracic ultrasound
• Sliding sign
• Pleurodesis