Ultrasound for Pleural Disease. Beyond a Pocket of Pleural Fluid

Patel, K.; Ullah, Kazi I.; Patail, Hassan; Ahmad, Sahar

doi:10.1513/annalsats.202008-948cme

Cited by 14 publications

(9 citation statements)

References 55 publications

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“…This finding supports previous literature, that concluded US guidance is comparable to CT guidance for pleural or peripheral lung lesions [35]. While CT may have a slight advantage in detecting these features due to its cross-sectional imaging capabilities and ability to visualize the entire thoracic cavity, US can also provide valuable information, particularly in assessing peripheral lung lesions [30,36].…”

Section: Discussionsupporting

confidence: 89%

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Shehata,

Almalki,

Basha

et al. 2024

Diagnostics

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Malignant pleural effusion (MPE) is a manifestation of advanced cancer that requires a prompt and accurate diagnosis. Ultrasonography (US) and computed tomography (CT) are valuable imaging techniques for evaluating pleural effusions; however, their relative predictive ability for a malignant origin remains debatable. This prospective study aimed to compare chest US with CT findings as predictors of malignancy in patients with undiagnosed exudative pleural effusion. Fifty-four adults with undiagnosed exudative pleural effusions underwent comprehensive clinical evaluation including chest US, CT, and histopathologic biopsy. Blinded radiologists evaluated the US and CT images for features suggestive of malignancy, based on predefined criteria. Diagnostic performance measures were calculated using histopathology as a reference standard. Of the 54 patients, 33 (61.1%) had MPEs confirmed on biopsy. No significant differences between US and CT were found in detecting parietal pleural abnormalities, lung lesions, chest wall invasion, or liver metastasis. US outperformed CT in identifying diaphragmatic pleural thickening ≥10 mm (33.3% vs. 6.1%, p < 0.001) and nodularity (45.5% vs. 3%, p < 0.001), whereas CT was superior for mediastinal thickening (48.5% vs. 15.2%, p = 0.002). For diagnosing MPE, diaphragmatic nodularity detected by US had 45.5% sensitivity and 100% specificity, whereas CT mediastinal thickening had 48.5% sensitivity and 90.5% specificity. Both US and CT demonstrate reasonable diagnostic performance for detecting MPE, with particular imaging findings favoring a malignant origin. US may be advantageous for evaluating diaphragmatic pleural involvement, whereas CT is more sensitive to mediastinal abnormalities.

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Section: Discussionsupporting

confidence: 89%

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Shehata,

Almalki,

Basha

et al. 2024

Diagnostics

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“…e Sagittal contrast-enhanced CT showing the retropharyngeal space (arrow). This lesion did not extend to the mediastinum [23,27]. Free-flowing effusion corresponds to simple exudative pleural effusion, septations or loculations correspond to fibrinopurulent pleural effusion, and visceral pleural thickening with trapped lung corresponds to organizing pleural effusion [23].…”

Section: Discussion Of the Interpretation Of The Sonographic Findings...mentioning

confidence: 93%

“…Ultrasound can evaluate pleural effusion, and the findings are classified based on the above-mentioned three stages [ 23 , 27 ]. Free-flowing effusion corresponds to simple exudative pleural effusion, septations or loculations correspond to fibrinopurulent pleural effusion, and visceral pleural thickening with trapped lung corresponds to organizing pleural effusion [ 23 ].…”

Section: Case Series and Data Sources Of The Literature Reviewmentioning

confidence: 99%

“…Free-flowing effusion corresponds to simple exudative pleural effusion, septations or loculations correspond to fibrinopurulent pleural effusion, and visceral pleural thickening with trapped lung corresponds to organizing pleural effusion [ 23 ]. Real-time lung ultrasound may evaluate lung motion and may determine the presence or absence of trapped lungs [ 27 ].…”

Section: Case Series and Data Sources Of The Literature Reviewmentioning

confidence: 99%

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Role of ultrasound in the treatment of pediatric infectious diseases: case series and narrative review

et al. 2022

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Background Infectious diseases are common in pediatric patients. In these patients, ultrasound is a useful imaging modality that involves no irradiation or sedation and can be performed repeatedly at the patient’s bedside. The purpose of this review was to show pediatric cases with infectious disease that used ultrasound to decide the methods of treatment. Data sources Literature review was performed using Pubmed as the medical database source. No year-of-publication restriction was placed. The mesh terms used were: “ultrasound”, “sonography”, “infectious disease”, “treatment”, “antibiotics”, “surgical intervention”, “pediatric”, “children”, “deep neck abscess”, “pyothorax”, “empyema”, “pneumonia”, “urinary tract infection”, “intra-abdominal abscess”, “soft tissue infection”, “septic arthritis”, “osteomyelitis”, and “surgical site infection”. Results We presented pediatric case series with infectious diseases, including deep neck abscess, pyothorax and empyema, pneumonia, urinary tract infection, intra-abdominal abscess, soft tissue infection, septic arthritis and osteomyelitis, and surgical-site infection. Ultrasound was useful for evaluating the extent and location of inflammation and abscess and for decision-making concerning surgical intervention. Conclusion Knowledge of these sonographic findings is important for sonographers during examinations and for physicians when determining the treatment plan and period of antibiotic therapy for infected lesions.

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“…It is exceedingly unlikely to diagnose a pleural effusion when the volume of fluid is less than 300 mL. The diagnostic performance of anteroposterior projection in standard chest radiography is limited, and it is only effective in cases where the volume of pleural effusion exceeds 200 mL [ 43 ].…”

Section: Reviewmentioning

confidence: 99%

Home Ultrasound: A Contemporary and Valuable Tool for Palliative Medicine

Monteiro,

França de Santana,

Morais

et al. 2024

Cureus

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This narrative review explores the application of point-of-care ultrasound (POCUS) in palliative care and its feasibility in home care settings. POCUS has the potential to streamline diagnostic strategies without patient transfer to the hospital, expedite timely symptomatic relief, and reduce complications from specific palliative interventions. The advent of handheld ultrasound devices has made it an attractive diagnostic and interventional adjunct in acute palliative care. POCUS has gained widespread acceptance as part of routine care in emergency medicine and intensive care, guiding certain procedures and increasing their safety. The modernization and miniaturization of ultrasound equipment have made ultra-portable devices available, allowing for better-quality images at affordable prices. Handheld devices have the potential to revolutionize everyday clinical practice in home-based palliative care, contributing to important bedside clinical decisions. Palliative care patients often require diagnostic examinations in the last months of their lives, with CT being the most frequently performed imaging procedure. However, CT imaging is associated with high costs and burdens, leading to increased suffering and impaired quality of life. Clinical ultrasound, a dialogic imaging modality, offers a safer and more efficient approach to palliative care. POCUS applications, which are cost-effective, non-invasive, and well-tolerated, can be used to improve patient satisfaction and diagnostic understanding. POCUS is a valuable tool in palliative care, improving diagnostic accuracy and reducing the time to diagnosis for various pathologies. It is a standard of care for many procedures and improves patient safety. However, there are limitations to POCUS in palliative care, such as operator-dependent examination variability and limited availability of trained professionals. To overcome these limitations, palliative care physicians should receive mandatory training in POCUS, which can be incorporated into the core curriculum. Additionally, ultrasound teleconsulting can assist less experienced examiners in real-time examinations. The literature on POCUS in palliative care is limited, but research on patient-oriented outcomes is crucial. POCUS should be considered a supplement to good clinical reasoning and regulated radiological evaluations.

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Ultrasound for Pleural Disease. Beyond a Pocket of Pleural Fluid

Cited by 14 publications

References 55 publications

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Comparative Evaluation of Chest Ultrasonography and Computed Tomography as Predictors of Malignant Pleural Effusion: A Prospective Study

Role of ultrasound in the treatment of pediatric infectious diseases: case series and narrative review

Home Ultrasound: A Contemporary and Valuable Tool for Palliative Medicine

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