Diagnostic Value of Chest Radiographs in Bedridden Patients Suspected of Having Pneumonia

Esayag, Yaacov; Никитин, И. Г.; Bar‐Ziv, Jacob; Cytter, Ruth; Hadas‐Halpern, Irith; Zalut, Todd; Yinnon, Amos M.

doi:10.1016/j.amjmed.2009.09.012

Cited by 109 publications

(94 citation statements)

References 9 publications

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“…19 The role of chest radiographs in the diagnosis of pneumonia, however, has been discussed controversially, because the sensitivity of chest radiographs for the de-tection of infiltrates is poor. 20 Therefore, we chose a more pragmatic approach in daily clinical care and treated all patients with clinical and laboratory and/or radiologic examinations suggestive of pneumonia. Accordingly, we chose to include these patients in our pneumonia analysis and to rather overestimate than underestimate pneumonia rates.…”

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confidence: 99%

Clinical Impact of Ventilation Duration in Patients with Stroke Undergoing Interventional Treatment under General Anesthesia: The Shorter the Better?

Nikoubashman

Schürmann

Probst³

et al. 2016

AJNR Am J Neuroradiol

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confidence: 99%

Clinical Impact of Ventilation Duration in Patients with Stroke Undergoing Interventional Treatment under General Anesthesia: The Shorter the Better?

Nikoubashman

Schürmann

Probst³

et al. 2016

AJNR Am J Neuroradiol

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“…Although CRs are used for the routine evaluation of patients with suspected pneumonia in the ER, low sensitivity and specificity are major limitations of CR, compared with those of CT. [1][2][3][4][6][7][8][9] CT, proven to be especially helpful when the CR diagnosis is unclear, has been mostly used as a supplement examination for pneumonia, as recommended by the 2007 IDSA/ATS consensus guidelines for community-acquired pneumonia. 5 In addition, outcome-based literature on the value of chest CT in adults with pneumonia who are immune competent is to date limited.…”

Section: Discussionmentioning

confidence: 99%

“…Low-dose CT (LDCT) is sometimes performed in patients with suspected ALRI, since LDCT is superior to CRs in the detection of pneumonia. [1][2][3][4] The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) consensus on the management of community-acquired pneumonia is that the role of CT scans in the diagnosis of pneumonia is inconclusive. Instead, for patients with a negative CR but toxic appearance suggestive of more than bronchitis, the IDSA/ATS recommends repeating the CR.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of low-dose CT scan in elderly patients with suspected acute lower respiratory infection in the emergency room

Park

Kim

Lee

et al. 2016

BJR

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Objective: To evaluate the usefulness of low-dose CT (LDCT) for the diagnosis of acute lower respiratory infection (ALRI) in elderly patients in the emergency room (ER). Methods: A total of 160 consecutive patients (mean age: 75.9 6 9.2 years; range: 60-97 years), who were diagnosed to have ALRI by LDCT in the ER, were enrolled in this study. Initial chest radiograph (CR) and CT patterns of ALRI were analysed, and clinical courses of patients were assessed. Results: 49 patients showed negative CR, in whom the main CT patterns were diffuse bronchial wall thickening (n 5 23), ground-glass opacity (n 5 6), mixed centrilobular nodules and ground-glass opacity (n 5 3), small consolidation (n 5 8) or consolidation in the dependent lung (n 5 9), while the other 111 patients with the main CT pattern of consolidation demonstrated pulmonary abnormality on CR. Pulmonary oedema (12.5%) and pleural effusion (23.1%) were associated. The rate of hospitalization, care in the intensive care unit, mortality and comorbidity were significantly higher in the CR(1)LDCT(1) group (88.3%, 36.1%, 18.2% and 59.5%) than in the CR(2)LDCT (1) group (55.1%, 8.2%, 2.0% and 38.8%; p # 0.05). Conclusion: LDCT was useful for the early diagnosis of ALRI in elderly patients who showed negative initial CR. The patients with negative initial CR had main CT patterns of diffuse bronchial wall thickening, ground-glass opacity, centrilobular nodules, small consolidation or consolidation in the dependent lung on LDCT. Advances in knowledge: The use of LDCT may be considered for the early diagnosis of ALRI in elderly patients who have high comorbidity. INTRODUCTIONWith increasing global life expectancy and the number of persons aged 65 years and older in the general population, the population of the elderly suffering from acute lower respiratory infection (ALRI) is increasing. Elderly people are more susceptible to pulmonary infection, owing to their decreased immunity and chronic comorbid illness. Complications, including septic shock or acute respiratory distress syndrome, can be life threatening. However, the diagnosis of ALRI in the elderly is often difficult owing to its non-specific manifestations, 1 because the symptoms and signs in elderly patients can differ from the general population and are sometimes not specific.

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“…Furthermore, high accuracy of 94 % was calculated. For detecting pathologies like pleural effusion and pneumonia on chest radiographs in the supine position, sensitivities/specificities/accuracies of 67 %/70 %/69 % [18] and 65 %/93 %/ 67 % [19], respectively, were reported. Due to the small number of patients that underwent CTCA and thoracic CT during the same imaging session, decided subdivision of sensitivities, specificities, and accuracies for the different pathologies could not be analyzed in our study.…”

Section: Sensitivity Specificity Ppv Npv and Accuracymentioning

confidence: 99%

Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography

Groth

Fiehler

Henes

et al. 2015

Fortschr Röntgenstr

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Purpose: To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings. Materials and Methods: The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT. Results: TPF were detected in 165 (33?%) SVBT. The five most common pathologic findings were: pleural effusion, 12?%; pneumonia, 8?%; atelectasis/dystelecatsis, 6?%; pericardial effusion, 2?% and elevated diaphragm, 1?%. For 48?% of these findings medical treatment was initiated. SVBT showed a sensitivity of 53?%, a specificity of 99?%, a positive predictive value of 89?%, a negative predictive value of 94?% and accuracy of 94?% for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement. Conclusion: SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account. Key points: ??Thoracic pathologies are frequently found on scout views for cerebral CTA ??Reviewing additional bolus trigger slices will improve diagnostic sensitivity ??Despite high specificity, scout views and trigger slices offer a moderate sensitivity ??Evaluation of scout views and trigger slices can result in medical treatment Citation Format: ??Groth M, Fiehler J, Henes FO et?al. Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography. Fortschr R?ntgenstr 2015; 187: 691???696

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Diagnostic Value of Chest Radiographs in Bedridden Patients Suspected of Having Pneumonia

Cited by 109 publications

References 9 publications

Clinical Impact of Ventilation Duration in Patients with Stroke Undergoing Interventional Treatment under General Anesthesia: The Shorter the Better?

Clinical Impact of Ventilation Duration in Patients with Stroke Undergoing Interventional Treatment under General Anesthesia: The Shorter the Better?

The usefulness of low-dose CT scan in elderly patients with suspected acute lower respiratory infection in the emergency room

Thoracic Pathologies on Scout Views and Bolus Tracking Slices for Computed Tomographic Cerebral Angiography

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