Is chest sonography a breakthrough in diagnosis of pulmonary thromboembolism in children?

Abstract

Bedside chest ultrasound examination is especially useful in children with high risk of PTE and in critical general condition. In newborns in severe general condition ultrasound examination of chest should be first imaging test for PTE. It is significant to set on a multicenter study to evaluate the diagnostic value of chest ultrasound in diagnosis of PTE in children.

Bedside Transthoracic Sonography in Suspected Pulmonary Embolism: A New Tool for Emergency Physicians

“…The overall number of lesions found with sonography was higher than by CT, but TUS measured them significantly smaller. 22 Results from studies for TUS for PE in children were recently reported by Kosiak et al 26 and also showed promising results. All investigators concluded that TUS is a highly specific complementary or alternate tool and should be considered in the emergency setting for patients unable to receive a CT or in the pediatric setting.…”

“…Sonographic findings of PE on transthoracic US (TUS) are well described [13][14][15][16][22][23][24][25][26][27][28][29] and correlate with the pathophysiologic results found on autopsy in patients diagnosed with PE and on helical CT. 28,30,31 Sonomorphology can be divided into parenchymal and pleural pathology. Typical parenchymal pathology includes multiple hypoechoic areas of lung tissue extending to the pleura.…”

“…13,14,[28][29][30] Pleural findings consist of localized or basal pleural effusions and can be found in up to two-thirds of patients with PE. [22][23][24][25][26][27] They correspond to the site of the parenchymal lesion. 14,[22][23][24][25][26][27][28][29] Interestingly, several investigators have found that the majority of detected PEs are found in the lower lung lobes, also noting that the localization of the parenchymal and pleural defects correlate with the area of pleuritic chest pain.…”

“…[22][23][24][25][26][27] They correspond to the site of the parenchymal lesion. 14,[22][23][24][25][26][27][28][29] Interestingly, several investigators have found that the majority of detected PEs are found in the lower lung lobes, also noting that the localization of the parenchymal and pleural defects correlate with the area of pleuritic chest pain. 22,24,25 Given the rising concern over radiation exposure and projected increased cancer risk, 8,10,11 it is not surprising that investigators have sought to determine if TUS can be used as an alternative or complementary imaging modality for PE.…”

Diagnostic accuracy of lung ultrasound for pulmonary embolism: a systematic review and meta‐analysis

“…Six extra papers were found after reviewing the reference lists. The remaining 13 studies were retrieved in full for detailed evaluation [12][13][14][15][16][17][18][19][20][21][22][23][24]. Agreement between reviewers for study selection was substantial (k = 0.75).…”