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Evaluation of the lung in children with suspected pneumonia: usefulness of ultrasonography

Valutazione del quadro polmonare nei pazienti pediatrici con sospetto clinico di polmonite: apporto dell’ecografia

La radiologia medica volume 114, pages 321–330 (2009)Cite this article

Abstract

Purpose

The authors sought to evaluate the sensitivity of chest ultrasound (US) versus chest radiography in detecting lung consolidation and pleural effusion in children with a clinical suspicion of pneumonia.

Materials and methods

Thirty-two chest radiographs and 32 chest US examinations were performed in 28 consecutive patients (aged 4 months to 17 years) with a clinical suspicion of pneumonia. Chest US examinations were carried out with a convex-array broadband probe (2–5 MHz) and a high-frequency linear-array broadband probe (5–12 MHz). The results obtained were compared with those of chest radiography.

Results

Chest radiography identified subpleural consolidation in 22 patients, perihilar consolidation in 7, and pleural effusion in eight. In the same 22 patients, chest US showed 22 cases of subpleural consolidation but no cases of perihilar consolidation; pleural effusion was detected in 15 patients.

Conclusions

Chest US is capable of identifying subpleural consolidation with the same sensitivity as chest radiography and is highly accurate in demonstrating pleural effusion. For this reason, chest US may be a valuable aid and possible alternative to standard chest radiography in the evaluation and follow-up of children with suspected pneumonia.

Riassunto

Obiettivo

Valutare la sensibilità dell’ecografia della parete toracica, rispetto all’Rx torace nei pazienti pediatrici con sospetta polmonite nell’identificazione di addensamenti polmonari e versamento pleurico.

Materiali e metodi

In 28 pazienti consecutivi, con esame obiettivo sospetto per polmonite (di età tra 4 mesi e 17 anni) sono stati eseguiti, considerando sia gli esami all’esordio che i controlli, 32 radiogrammi del torace ed altrettante ecografie della parete toracica. Quest’ultimo esame è stato condotto mediante sonda convex ad ampia banda (2–5 MHz) e sonda lineare ad alta frequenza ad ampia banda (5–12 MHz), confrontando i risultati ottenuti con quelli dell’Rx.

Risultati

Globalmente l’Rx ha dimostrato in 22 pazienti la presenza di addensamenti subpleurici, in 7 addensamenti a sede parailare ed in 8 versamento pleurico. Nei medesimi pazienti l’ecografia ha riscontrato 22 addensamenti subpleurici, nessuno esclusivamente in sede parailare ed in 15 pazienti presenza di versamento pleurico.

Conclusioni

L’ecografia permette di identificare gli addensamenti parenchimali polmonari, qualora siano situati in sede subpleurica, quantomeno con la stessa sensibilità dell’Rx e come noto valuta molto bene il versamento pleurico. Pertanto l’ecografia si pone come un valido supporto ed eventuale alternativa agli esami radiologici tradizionali nel monitoraggio dei pazienti pediatrici.

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Affiliations

  1. Istituto di Radiologia Policlinico Universitario di Udine, Via Colugna 50, 33100, Udine, Italy

    D. Iuri, A. De Candia & M. Bazzocchi

Authors
  1. D. Iuri
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  2. A. De Candia
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  3. M. Bazzocchi
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Corresponding author

Correspondence to D. Iuri.

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Iuri, D., De Candia, A. & Bazzocchi, M. Evaluation of the lung in children with suspected pneumonia: usefulness of ultrasonography. Radiol med 114, 321–330 (2009). https://doi.org/10.1007/s11547-008-0336-8

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  • DOI: https://doi.org/10.1007/s11547-008-0336-8

Keywords

  • Thoracic sonography
  • Lung consolidation
  • Pleural effusion
  • Pneumonia

Parole chiave

  • Ecografia toracica
  • Addensamenti polmonari
  • Versamento pleurico
  • Polmonite