Quantification of pleural effusions: sonography versus radiography.

Eibenberger, K.; Dock, W; Ammann, Markus; Dorffner, Roland; Hörmann, Marcus; F, Grabenwöger

doi:10.1148/radiology.191.3.8184046

Cited by 315 publications

(207 citation statements)

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“…Scans of the basal pleurae and the diaphragm should be obtained with the patient seated and then (when possible) in the supine position. In rare cases, the patient may be asked to stand during the examination (e.g., when the costophrenic recess is being explored for a possible effusion) [6,7]. Various scanning planes can be used: intercostal, longitudinal, transversal, and paravertebral scans can be used to explore the posterior chest wall, whereas the anterior wall is usually investigated with intercostal, longitudinal, supra-and parasternal, sub-xiphoid, and supraclavicular scans.…”

Section: Techniquementioning

confidence: 99%

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo

Filabozzi

Varriale

et al. 2008

Journal of Ultrasound

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Although numerous studies have been conducted on the use of ultrasonography (US) for the examination of thoracic structures, this procedure is not as widely accepted as abdominal US. The newer portable scanners can be used at the bedside to detect pleural malignancies and effusions, as well as peripheral lung nodules of the lung, even in seriously ill patients. Focal thickening of the pleura can be easily detected with US and further investigated with a US-guided biopsy. US guidance can also be used during percutaneous drainage of pleural effusion or transthoracic biopsy of peripheral lung lesions, thus reducing the incidence of procedure-related pneumothorax to almost zero. We review the current literature on thoracic US and present our clinical experience with the technique in large groups of patients with pleural and peripheral lung diseases.Sommario L'ecografia del torace non è ancora diffusa quanto quella addominale, nonostante una notevole quantità di studi ne attesti l'importanza. Le apparecchiature più recenti permettono di diagnosticare neoplasie, versamenti pleurici e noduli polmonari periferici al letto del paziente, anche nei casi più gravi. L'ispessimento pleurico focale è facilmente messo in luce dall'ecografia e può essere ulteriormente studiato tramite la biopsia ecoguidata. Questa può essere praticata anche su lesioni polmonari periferiche, riducendo quasi a zero il rischio di pneumotorace. In questo articolo esaminiamo la letteratura recente sull'ecografia del torace e presentiamo la nostra esperienza clinica su numerosi pazienti con patologia pleurica e della periferia polmonare. ª

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Section: Techniquementioning

confidence: 99%

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo

Filabozzi

Varriale

et al. 2008

Journal of Ultrasound

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“…In recent years, studies have shown that sonography achieves better results than radiography in measuring the effusion volume. [8][9][10][11] However, the confidence intervals for such measurements remain wide. For this reason, and because of the heterogeneity of the methods proposed in different studies, large-scale use of sonography has been impeded.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of sonography for pleural effusion: systematic review

et al. 2010

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CONTEXT AND OBJECTIVE: The initial method for evaluating the presence of pleural effusion was chest radiography. Isolated studies have shown that sonography has greater accuracy than radiography for this diagnosis; however, no systematic reviews on this matter are available in the literature. Thus, the aim of this study was to evaluate the accuracy of sonography in detecting pleural effusion, by means of a systematic review of the literature. DESIGN AND SETTING:This was a systematic review with meta-analysis on accuracy studies. This study was conducted in the Department of Diagnostic METHOD:The following databases were searched: Cochrane Library, Medline, Web of Science, Embase and Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). The references of relevant studies were also screened for additional citations of interest. Studies in which the accuracy of sonography for detecting pleural effusion was tested, with an acceptable reference standard (computed tomography or thoracic drainage), were included.RESULTS: Four studies were included. All of them showed that sonography had high sensitivity, specificity and accuracy for detecting pleural effusions. The mean sensitivity was 93% (95% confidence interval, CI: 89% to 96%), and specificity was 96% (95% CI: 95% to 98%). CONCLUSIONS:In different populations and clinical settings, sonography showed consistently high sensitivity, specificity and accuracy for detecting fluid in the pleural space.RESUMO CONTEXTO E OBJETIVOS: O método inicial para a avaliação da presença dos derrames pleurais foi a radiografia de tórax. Estudos isolados demonstraram que a ultrassonografia apresenta uma acurácia maior que a radiografia para este diagnóstico, entretanto, não se encontram disponíveis na literatura revisões sistemáticas sobre este tema. Assim, o objetivo deste estudo é avaliar a acurácia da ultrassonografia na detecção de derrame pleural, por meio de revisão sistemática da literatura. Caribe em Ciências da Saúde (Lilacs). As referências de estudos relevantes foram verificadas para adicionais citações de interesse. Foram incluídos estudos nos quais a acurácia da ultrassonografia para a detecção de derrame pleural tenha sido testada, com padrão referência aceitável (tomografia computadorizada ou drenagem torácica). TIPO DE ESTUDO E LOCAL: RESULTADOS:Foram incluídos quatro estudos. Todos apresentaram alta sensibilidade, especificidade e acurácia para a detecção de derrame pleural pela ultrassonografia. A sensibilidade média foi de 93% (intervalo de confiança, IC 95%: 89% a 96%), e a especificidade 96% (IC 95%: 95% a 98%). CONCLUSÕES:A ultrassonografia, em diferentes populações e cenários clínicos, apresentou consistentemente alta sensibilidade, especificidade e acurácia na detecção de líquido no espaço pleural.

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“…Since previous studies have established a method of correlating measurements between LDR and ultrasound [12], and between LDR and LER [8], it should be possible to define a correlation between measurements with LDR and CCT. This measurement can be used to define the need for thoracentesis once a PPE is documented by CCT.…”

mentioning

confidence: 99%

Computed tomography measurements of parapneumonic effusion indicative of thoracentesis

Moffett

Panchabhai²,

Anaya³

et al. 2011

Eur Respir J

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Patients with parapneumonic effusions (PPE) measuring ,1 cm by lateral decubitus radiograph (LDR) or ,5 cm by lateral erect radiograph (LER) do not require thoracentesis. No such data exist for chest computed tomography (CCT). The objective of this study was to identify a PPE measurement by CCT that indicates the need for thoracentesis.A secondary data analysis of two pneumonia databases was conducted to identify patients with PPE. Measurements of PPE using LDR, LER and CCT were correlated by linear regression analysis. The clinical outcome of community-acquired pneumonia patients managed with the newly defined CCT measurement was evaluated.PPE was identified in 419 out of 1,460 patients with possible pneumonia. PPE measurements of 1 cm and 5 cm by LDR and LER, respectively, correlated with a measurement of 2.5 cm by CCT. Out of 95 patients with CCT measurements ,2.5 cm, 31 poor clinical outcomes were reported: outcome was PPE related (n51); outcome was PPE unrelated (n526); and outcome was not evaluable (n54). The single case of poor outcome also measured ,1 cm by LDR.This study indicates that patients with community-acquired pneumonia and a PPE measuring ,2.5 cm by CCT can be managed without the need for thoracentesis.

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Quantification of pleural effusions: sonography versus radiography.

Abstract: In quantification of pleural effusions, the sonographic measurement method presented is preferable to radiographic measurement.

Cited by 315 publications

References 0 publications

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Diagnostic accuracy of sonography for pleural effusion: systematic review

Computed tomography measurements of parapneumonic effusion indicative of thoracentesis

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