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Quantitative analysis of lung ultrasonography for the detection of community-acquired pneumonia: a pilot study.

Corradi F, Brusasco C, Garlaschi A, Paparo F, Ball L, Santori G, Pelosi P, Altomonte F, Vezzani A, Brusasco V - Biomed Res Int (2015)

Bottom Line: In this study, the diagnostic performance of a new method for quantitative analysis of lung ultrasonography was compared with bedside chest X-ray and visual lung ultrasonography for detection of community-acquired pneumonia, using thoracic computed tomography as a gold standard.Each hemithorax was evaluated for the presence or absence of abnormalities by chest X-ray and quantitative or visual ultrasonography.Quantitative ultrasonography showed higher sensitivity (93%), specificity (95%), and diagnostic accuracy (94%) than chest X-ray (64%, 80%, and 69%, resp.), visual ultrasonography (68%, 95%, and 77%, resp.), or their combination (77%, 75%, and 77%, resp.).

View Article: PubMed Central - PubMed

Affiliation: Anaesthesia and Intensive Care Unit, Galliera Hospital, 16100 Genoa, Italy.

ABSTRACT

Background and objective: Chest X-ray is recommended for routine use in patients with suspected pneumonia, but its use in emergency settings is limited. In this study, the diagnostic performance of a new method for quantitative analysis of lung ultrasonography was compared with bedside chest X-ray and visual lung ultrasonography for detection of community-acquired pneumonia, using thoracic computed tomography as a gold standard.

Methods: Thirty-two spontaneously breathing patients with suspected community-acquired pneumonia, undergoing computed tomography examination, were consecutively enrolled. Each hemithorax was evaluated for the presence or absence of abnormalities by chest X-ray and quantitative or visual ultrasonography.

Results: Quantitative ultrasonography showed higher sensitivity (93%), specificity (95%), and diagnostic accuracy (94%) than chest X-ray (64%, 80%, and 69%, resp.), visual ultrasonography (68%, 95%, and 77%, resp.), or their combination (77%, 75%, and 77%, resp.).

Conclusions: Quantitative lung ultrasonography was considerably more accurate than either chest X-ray or visual ultrasonography in the diagnosis of community-acquired pneumonia and it may represent a useful first-line approach for confirmation of clinical diagnosis in emergency settings.

No MeSH data available.


Related in: MedlinePlus

Mean echo intensity (Gray units) by quantitative lung ultrasonography from nonaffected (CT−) and affected (CT+) hemithoraxes with positive (LUS+) or negative (LUS−) results. CT: computed tomography; LUS: visual lung ultrasonography.
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fig2: Mean echo intensity (Gray units) by quantitative lung ultrasonography from nonaffected (CT−) and affected (CT+) hemithoraxes with positive (LUS+) or negative (LUS−) results. CT: computed tomography; LUS: visual lung ultrasonography.

Mentions: QLUS provided mean values of Gray units significantly lower in CT-negative (39 ± 9) than CT-positive (93 ± 26) hemithoraxes (P < .001). When all CT-positive hemithoraxes were divided into two subgroups based on LUS results, the mean Gray unit (Figure 2) was significantly (P < .001) higher in the LUS-positive (103 ± 21) than LUS-negative (73 ± 22) ones. Both subgroups were significantly different from the CT-negative group (P < .001). The best Gray Unit cut-off determined by ROC analysis (AUROC .971, SE .020, P < .001, and 95% CI: .932–1.000) was 48, returning 95% sensitivity and 90% specificity. By using this cut-off for diagnosis of pneumonia, the sensitivity of QLUS was of 93% (Table 2).


Quantitative analysis of lung ultrasonography for the detection of community-acquired pneumonia: a pilot study.

Corradi F, Brusasco C, Garlaschi A, Paparo F, Ball L, Santori G, Pelosi P, Altomonte F, Vezzani A, Brusasco V - Biomed Res Int (2015)

Mean echo intensity (Gray units) by quantitative lung ultrasonography from nonaffected (CT−) and affected (CT+) hemithoraxes with positive (LUS+) or negative (LUS−) results. CT: computed tomography; LUS: visual lung ultrasonography.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4355628&req=5

fig2: Mean echo intensity (Gray units) by quantitative lung ultrasonography from nonaffected (CT−) and affected (CT+) hemithoraxes with positive (LUS+) or negative (LUS−) results. CT: computed tomography; LUS: visual lung ultrasonography.
Mentions: QLUS provided mean values of Gray units significantly lower in CT-negative (39 ± 9) than CT-positive (93 ± 26) hemithoraxes (P < .001). When all CT-positive hemithoraxes were divided into two subgroups based on LUS results, the mean Gray unit (Figure 2) was significantly (P < .001) higher in the LUS-positive (103 ± 21) than LUS-negative (73 ± 22) ones. Both subgroups were significantly different from the CT-negative group (P < .001). The best Gray Unit cut-off determined by ROC analysis (AUROC .971, SE .020, P < .001, and 95% CI: .932–1.000) was 48, returning 95% sensitivity and 90% specificity. By using this cut-off for diagnosis of pneumonia, the sensitivity of QLUS was of 93% (Table 2).

Bottom Line: In this study, the diagnostic performance of a new method for quantitative analysis of lung ultrasonography was compared with bedside chest X-ray and visual lung ultrasonography for detection of community-acquired pneumonia, using thoracic computed tomography as a gold standard.Each hemithorax was evaluated for the presence or absence of abnormalities by chest X-ray and quantitative or visual ultrasonography.Quantitative ultrasonography showed higher sensitivity (93%), specificity (95%), and diagnostic accuracy (94%) than chest X-ray (64%, 80%, and 69%, resp.), visual ultrasonography (68%, 95%, and 77%, resp.), or their combination (77%, 75%, and 77%, resp.).

View Article: PubMed Central - PubMed

Affiliation: Anaesthesia and Intensive Care Unit, Galliera Hospital, 16100 Genoa, Italy.

ABSTRACT

Background and objective: Chest X-ray is recommended for routine use in patients with suspected pneumonia, but its use in emergency settings is limited. In this study, the diagnostic performance of a new method for quantitative analysis of lung ultrasonography was compared with bedside chest X-ray and visual lung ultrasonography for detection of community-acquired pneumonia, using thoracic computed tomography as a gold standard.

Methods: Thirty-two spontaneously breathing patients with suspected community-acquired pneumonia, undergoing computed tomography examination, were consecutively enrolled. Each hemithorax was evaluated for the presence or absence of abnormalities by chest X-ray and quantitative or visual ultrasonography.

Results: Quantitative ultrasonography showed higher sensitivity (93%), specificity (95%), and diagnostic accuracy (94%) than chest X-ray (64%, 80%, and 69%, resp.), visual ultrasonography (68%, 95%, and 77%, resp.), or their combination (77%, 75%, and 77%, resp.).

Conclusions: Quantitative lung ultrasonography was considerably more accurate than either chest X-ray or visual ultrasonography in the diagnosis of community-acquired pneumonia and it may represent a useful first-line approach for confirmation of clinical diagnosis in emergency settings.

No MeSH data available.


Related in: MedlinePlus