Thoracic ultrasound may aid evaluation of complicated pneumonia
Thoracic ultrasound (US) may be a useful tool to further evaluate pulmonary complications in complicated pneumonia, especially if chest X-ray results are inconclusive, according to a presentation at the 21st Congress of the Asian Pacific Society of Respirology (APSR 2016) held in Bangkok, Thailand.
Thoracic US is a noninvasive diagnostic examination that can better detect pleural fluid septations with greater sensitivity than computed tomography (CT) scanning, said Dr Jirawadee Yodying from Body Intervention, Department of Radiology, Siriraj Hospital, Mahidol University.
Thoracic US is safe and inexpensive. It is portable, and can be carried out at bedside or in an ICU setting with no radiation exposure, particularly in children, said Yodying. “There is no radiation exposure as compared to CT.”
The British Thoracic Society (BTS) guidelines recommend US to confirm the presence of pleural fluid collection and guide thoracocentesis or drain placement, adding that chest CT should not be performed routinely. [Thorax 2005;60(Suppl I):i1–i21]
However, chest CT should be considered if a different diagnosis, such as malignancy, is suspected, according to the Canadian Paediatric Society. [Paeditr Child Health 2011;16:425-427]
Chest X-ray is usually the recommended imaging workup for an initial evaluation of the patient with suspected complication. Posteroanterior (PA) or anteroposterior (AP) view of the chest X-ray should be taken for investigation of pleural effusion and empyema, according to the researchers.
If the chest X-ray is inconclusive, then further imaging with thoracic US is strongly recommended for high-quality evidence of pleural fluid. [Clin Infect Dis 2011;53:e25-e76]