Chest sonography versus lateral decubitus radiography in the diagnosis of small pleural effusions

Kocijančič, Igor; Vidmar, Ksenija; Ivanovi-Herceg, Zlata

doi:10.1002/jcu.10141

Cited by 95 publications

(57 citation statements)

References 18 publications

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“…Lung ultrasound accuracy is proved to be higher than CXR, particularly when anterior-posterior view in the supine patient is considered [49,69,70]. Lung ultrasound performance is nearly as good as CT scan [49,80].…”

Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

“…In other conditions, such as complex effusion and in patients where pleural effusion is suspected, the sonographic technique can benefit from standardized criteria to improve diagnostic accuracy. The sinusoid sign is a dynamic sign showing the variation of the interpleural distance during the respiratory cycles [69,70]. This variation is easily visualized on M-mode as a sinusoid movement of the visceral pleura [70].…”

Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

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International evidence-based recommendations for point-of-care lung ultrasound

et al. 2012

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Background: The purpose of this study is to provide evidence-based and expert consensus recommendations for lung ultrasound with focus on emergency and critical care settings. Methods: A multidisciplinary panel of 28 experts from eight countries was involved. Literature was reviewed from January 1966 to June 2011. Consensus members searched multiple databases including Pubmed, Medline, OVID, Embase, and others. The process used to develop these evidence-based recommendations involved two phases: determining the level of quality of evidence and developing the recommendation. The quality of evidence is assessed by the grading of recommendation, assessment, development, and evaluation (GRADE) method. However, the GRADE system does not enforce a specific method on how the panel should reach decisions during the consensus process. Our methodology committee decided to utilize the RAND appropriateness method for panel judgment and decisions/consensus. Results: Seventythree proposed statements were examined and discussed in three conferences held in Bologna, Pisa, and Rome. Each conference included two rounds of face-to-face modified Delphi technique. Anonymous panel voting followed each round. The panel did not reach an agreement and therefore did not adopt any recommendations for six statements. Weak/ conditional recommendations were made for 2 statements, and strong recommendations were made for the remaining 65 statements. The statements were then recategorized and grouped to their current format. Internal and external peer-review processes took place before submission of the recommendations. Updates will occur at least every 4 years or whenever significant major changes in evidence appear. Conclusions: This document reflects the overall results of the first consensus conference on ''point-of-care'' lung ultrasound. Statements were discussed and elaborated by experts who published the vast majority of papers on clinical use of lung ultrasound in the last 20 years. Recommendations were produced to guide implementation, development, and standardization of lung ultrasound in all relevant settings.

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Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

Section: Rl-d4-s2 (Strong: Level B)mentioning

confidence: 99%

International evidence-based recommendations for point-of-care lung ultrasound

et al. 2012

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“…For ethical reasons the 5 patients with an LUS diagnosis of PE did not undergo further imaging (i.e., computed tomography) which would have potentially supported or excluded the LUS finding. Of note, previous literature demonstrated that LUS is more accurate than CXR in the diagnosis of small PEs in adults [25]. …”

Section: Discussionmentioning

confidence: 99%

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

et al. 2018

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Background: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. Objective: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. Methods: We enrolled newborns with RD during the first 24 h of life. Patients underwent LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. Results: We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86–96%) with a κ statistic of 0.88 (95% CI 0.81–0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5–15) than for CXR (50 min, IQR 33–64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5–15) than novice operators (15 min, IQR 10–20) (p < 0.0002). Conclusion: LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.

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“…10 The thoracic US is particularly useful in the intensive care unit setting where small effusion or the real amount of an effusion may be missed, especially when radiographs are made in a supine position, or when radiograms are shot with a sub optimal radiographic technique. 10,12,13 Though Ultrasound is sensitive but it is less specific for detecting minimal effusion. RG Wu et al 14 have observed that minimal or loculated (even 3 to 5 ml) effusions are readily detected by demonstrating "fluid color" sign by Doppler US with the sensitivity of 89.2% and specificity of 100%.…”

Section: Pleural Effusionsmentioning

confidence: 99%

Sonography Of The Lungs And Pleura

2007

J Liaquat Uni Med Health Sci

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The role of Transthoracic Sonography in the evaluation of chest diseases has already been accepted throughout the world. Though Ultrasound (US) is not widely established as a routine method, but the advantages of low-cost, bedside availability and lack of ionizing radiation exposure has made it an indispensable diagnostic tool in the modern pulmonary medicine. US supplements the conventional chest X-ray and computed tomography and closes the gap between them. Besides, it is invaluable in the interventional procedures of chest and pleural space and it is suited to critically ill patients in need of bedside investigations. This article reviews the sonographic morphology of the pleural and peripheral pulmonary diseases. KEY WORDS: Thoracic imaging. Pleural diseases. Pleural Neoplasm. Pulmonary lesions. Pulmonary malignancy.

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Chest sonography versus lateral decubitus radiography in the diagnosis of small pleural effusions

Abstract: Chest sonography showed a high degree of accuracy relative to that of lateral decubitus chest radiography in the diagnosis of small pleural effusions, which appeared as thin (usually 15 mm thick or less) anechoic areas that changed shape with the phases of respiration.

Cited by 95 publications

References 18 publications

International evidence-based recommendations for point-of-care lung ultrasound

International evidence-based recommendations for point-of-care lung ultrasound

Lung Ultrasound for the Differential Diagnosis of Respiratory Distress in Neonates

Sonography Of The Lungs And Pleura

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