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Can transthoracic ultrasound differentiate between simple and obstructed pneumonia?

Abstract

Background

The advantages of low cost, bedside availability, and no radiation exposure have made ultrasound an indispensable diagnostic tool in modern pulmonary medicine. Color Doppler ultrasound demonstrates normal or increased flow in the normal vessels of the consolidated lung and may be helpful in distinguishing simple pneumonia from postobstructive pneumonia.

Aim of the work

The aim of this work was to describe sonographic features of simple and obstructed pneumonia and discuss the value of transthoracic ultrasound to differentiate between both diseases.

Results

The study included 18 patients with simple pneumonia and seven patients with obstructed pneumonia. The sonographic findings were as follows: positive air bronchogram recorded in 100% of the cases of simple pneumonia, but not found in any case of obstructed pneumonia; fluid bronchogram not found in any case of simple pneumonia and present in 100% of obstructed pneumonia (P = 0.005). Oval and rounded shape, irregular shape, sharp well-demarcated, blurred-border, homogenous, heterogeneous, and hypoechoic echo patterns were found in 38.9, 61.1, 33.3, 66.7, 11.1, 88.9, and 100% of the cases of simple pneumonia and in 42.9, 57.1, 28.6, 71.4, 0, 100, and 85.7% of the cases of obstructed pneumonia, respectively. Pleural effusion was present in 44.4 and 42.9% of cases of simple and obstructed pneumonia, respectively. Fluid bronchogram was seen in the bronchial obstruction, as a result of either impacted secretions or a proximal tumor.

Conclusion

The presence of signs of fluid bronchogram in the appropriate clinical context should raise the suspicion of postobstructive pneumonitis. Transthoracic ultrasound helps in distinguishing the central obstructing tumor as a hypoechoic mass from distal more echogenic consolidations. Egypt J Broncho 2014 8:87–90

References

  1. Yu CJ, Yang PC, Chang DB, Luh KT. Diagnostic and therapeutic use of chest sonography: value in critically ill patients. Am J Roentgenol 1992; 159:695–701.

    Article  CAS  Google Scholar 

  2. Mathis G. Thorax sonography-part-2: peripheral pulmonary consolidation. Ultrasound Med Biol 1997; 23:1141–1153.

    Article  CAS  Google Scholar 

  3. Sperandeo M, Canevvale V, Muscarella S. Clinical application of transthoracic ultrasonography in patients with pneumonia. Eur J Clin Invest 2010; 41:1–7.

    Article  Google Scholar 

  4. Targhetta R, Chavagneux R, Bourgeois JM, Dauzat M, Balmes P, Pourcelot L. Sonographic approach to diagnosing pulmonary consolidation. J Ultrasound Med 1992; 11:667–672.

    Article  CAS  Google Scholar 

  5. Koh DM, Burke S, Davies N, Padley SPG. Transthoracic US of the chest: clinical uses and applications. Radiographs 2002; 22: e1.

    Article  Google Scholar 

  6. Beckh S, Boleskei PL, Lessnau KD. Real-time chest ultrasonography: a comprehensive review for the pulmonologist. Chest 2002; 122:1759–1773.

    Article  Google Scholar 

  7. Kurian J, Levin TL, Han BK, Taragin BH, Weinstein S. Comparison of ultrasound and CT in the evaluation of pneumonia complicated by parapneumonic effusion in children. Am J Roentgenol 2009; 193:1648–1654.

    Article  Google Scholar 

  8. Viegi G, Pistelli R, Cazzola M. Epidemiological survey on incidence and treatment of community acquired pneumonia in Italy. Respir Med 2006; 100:46–55.

    Article  Google Scholar 

  9. Yang PC. Color Doppler ultrasound of pulmonary consolidation. Eur J Ultrasound 1996; 3:169–178.

    Article  Google Scholar 

  10. Gehmacher O, Mathis G, Kopf A, Scheier M. Ultrasound imaging of pneumonia. Ultrasound Med Biol 1995; 21:1119–1122.

    Article  CAS  Google Scholar 

  11. Reissig A, Kroegel C. Sonographic diagnosis and follow-up of pneumonia: a prospective study. Respiration 2007; 74:537–547.

    Article  Google Scholar 

  12. Yang PC, Luh KT, Lee Chang DB. Ultrasound evaluation of pulmonary consolidation. Am Rev Respir Dis 1992; 146:757–762.

    Article  CAS  Google Scholar 

  13. Yang PC, Lee YC, Wu HD, Luh KT. Lung tumors associated with obstructive pneumonitis: US studies. Radiology 1990; 174:717–720.

    Article  CAS  Google Scholar 

Download references

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Correspondence to Randa E. Abd Elkader MD.

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Agmy, G.R., Wafy, S.M., Mohamed Hussein, A.A.R. et al. Can transthoracic ultrasound differentiate between simple and obstructed pneumonia?. Egypt J Bronchol 8, 87–90 (2014). https://doi.org/10.4103/1687-8426.145695

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