Can Chest Computed Tomography Be Replaced by Lung Ultrasonography With or Without Plain Chest Radiography in Pediatric Pneumonia?

Hajalioghli, Parisa; Nemati, Masoud; Saleh, Leila Dinparast; Fouladi, Daniel Fadaei

doi:10.1097/rti.0000000000000209

Cited by 27 publications

(32 citation statements)

References 39 publications

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“…The air bronchogram was only identified by chest CT. The results from the present study were consistent with prospective studies (16,18) and retrospective reviews on adult patients (13,14). However, the results obtained were not in line with a prospective observational cohort study on lung ultrasound in children and young adults (19).…”

Section: Discussionsupporting

confidence: 58%

“…The amount of experience each sonographer has can also impact the accuracy of the ultrasound findings (9). Furthermore, lung ultrasound has fewer accuracies in identifying lung abscesses than chest CT (16). Combining lung ultrasound and chest X-ray has been reported to display results consistent with chest CT (16), however, the present study did not include such analysis.…”

Section: Imaging Modality -------------------------------------------mentioning

confidence: 81%

“…CT scans were performed by radiologists (≥5 years' experience; blinded regarding results of clinical examinations, chest X-rays and lung ultrasound) at each institute. Images were analyzed by radiologists in consultation with pulmonologists (≥3 years' experience) at each institute (16). When images were reviewed, ≥3 independent interpretations of the results were performed.…”

Section: Ethicsmentioning

confidence: 99%

“…The present study performed chest CT to confirm pneumonia, but generally chest CT is not preferred as a diagnostic module in children for safety reasons. Typically, there is less inter-and intra-operator reproducibility for lung ultrasound than chest X-ray (16). The amount of experience each sonographer has can also impact the accuracy of the ultrasound findings (9).…”

Section: Imaging Modality -------------------------------------------mentioning

confidence: 99%

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Lung ultrasound vs. chest X‑ray in children with suspected pneumonia confirmed by chest computed tomography: A retrospective cohort study

et al. 2019

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The chest X-ray is routinely requested by pediatricians for children with suspected pneumonia, but has been demonstrated to be an insensitive method with relatively low accuracy. Computed tomography (CT) allows for the characterization of the consolidation in pneumonia but has a high risk of radiation exposure in children. Lung ultrasonography can identify subpleural lung consolidation in adults, but it is not accepted in routine clinical practice and is also not used for the diagnosis of children with pneumonia. The objective of the present study was to compare diagnostic parameters of lung ultrasound with chest X-ray in children with suspected pneumonia, using CT as a reference standard. Medical records of 949 children, aged ≤16 years, with suspected pneumonia were reviewed. Data regarding the chest radiograph, lung ultrasound and chest CT were collected and analyzed. Beneficial score analysis for each diagnostic modality was evaluated according to the pneumonia severity index. The chest radiograph successfully detected subpleural lung consolidation and dense lung opacity. The lung ultrasound successfully detected pleural effusion and perilesional inflammatory edema. The chest CT successfully detected a liquefied area, enhancement and necrosis of the lungs. Compared with the chest CT, the lung ultrasound displayed 0.906 sensitivity and 0.661 accuracy, while the chest radiograph displayed 0.793 sensitivity and 0.559 accuracy. For a pneumonia severity index of <3, the chest CT displayed a good beneficial score, followed by the lung ultrasound and chest radiograph. In conclusion, lung ultrasound is a non-invasive and simple method that could be used for the diagnosis of suspected pneumonia in children.

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Section: Discussionsupporting

confidence: 58%

Section: Imaging Modality -------------------------------------------mentioning

confidence: 81%

Section: Ethicsmentioning

confidence: 99%

Section: Imaging Modality -------------------------------------------mentioning

confidence: 99%

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Lung ultrasound vs. chest X‑ray in children with suspected pneumonia confirmed by chest computed tomography: A retrospective cohort study

et al. 2019

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“…Pleural effusions: chest CT may be replaced by a POCUS with or without chest radiography in evaluating complex effusions/empyema [197]. …”

Section: Diagnostic Applications Of Ultrasoundmentioning

confidence: 99%

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

et al. 2016

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The utility of point-of-care ultrasound is well supported by the medical literature. Consequently, pediatric emergency medicine providers have embraced this technology in everyday practice. Recently, the American Academy of Pediatrics published a policy statement endorsing the use of point-of-care ultrasound by pediatric emergency medicine providers. To date, there is no standard guideline for the practice of point-of-care ultrasound for this specialty. This document serves as an initial step in the detailed “how to” and description of individual point-of-care ultrasound examinations. Pediatric emergency medicine providers should refer to this paper as reference for published research, objectives for learners, and standardized reporting guidelines.

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Eminence‐Based Versus Evidence‐Based Imaging of Lung Infection (Pneumonia) in Children – Diagnostic Accuracy of Lung Ultrasound

Venkatakrishna,

Sultan,

McShea

et al. 2024

Pediatric Pulmonology

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PurposeLung ultrasound (LUS) has been widely used for detecting pneumonia in children. Although LUS offers multiple advantages, its diagnostic accuracy compared to an imaging gold standard, e.g., computed tomography (CT) is in question. We evaluated the existing literature comparing the use of LUS for diagnosing pneumonia in children to CT.MethodsPubMed, EMBASE and Scopus databases were searched for relevant studies published from inception to June 13, 2024, using controlled vocabulary (MESH, EMTREE) with keywords.ResultsThe initial search identified 1065 articles. After the removal of duplicates (n = 350), the abstracts and titles of 715 studies were screened. 34 relevant studies were reviewed in detail for eligibility and shortlisted to 19 studies. Only 5 usable studies were identified. Of the five studies, three were published in journals that are not indexed in MEDLINE. The study with largest sample size (949 children) reported a sensitivity of LUS of 0.906 with 0.661 accuracy in comparison to chest CT.ConclusionThere was very limited and relatively low‐quality current evidence regarding the accuracy of LUS in comparison to CT for diagnosing pneumonia in children.

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Can Chest Computed Tomography Be Replaced by Lung Ultrasonography With or Without Plain Chest Radiography in Pediatric Pneumonia?

Abstract: CT can be replaced by US when complex effusions are present in children with pneumonia. In case of an ambiguous diagnosis of pediatric pneumonia with or without complex effusions, a combination of chest radiography and US is a reliable surrogate for chest CT.

Cited by 27 publications

References 39 publications

Lung ultrasound vs. chest X‑ray in children with suspected pneumonia confirmed by chest computed tomography: A retrospective cohort study

Lung ultrasound vs. chest X‑ray in children with suspected pneumonia confirmed by chest computed tomography: A retrospective cohort study

Pediatric emergency medicine point-of-care ultrasound: summary of the evidence

Eminence‐Based Versus Evidence‐Based Imaging of Lung Infection (Pneumonia) in Children – Diagnostic Accuracy of Lung Ultrasound

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