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The Egyptian Journal of Bronchology
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Chest ultrasound versus chest computed tomography for imaging assessment before medical thoracoscopy

Egyptian Journal of Bronchology volume 8, pages 149–152 (2014)Cite this article

Abstract

Background and objective

The aim of this work was to assess the concordance between chest ultrasound (US) and chest computed tomography (CT) findings before medical thoracoscopy (MT) and the impact of the findings on the conduct and outcome of MT.

Materials and methods

The study was conducted prospectively on 52 patients referred for MT. All patients received chest X-ray (CXR), chest US, and chest CT before the procedure. Images were evaluated and findings were correlated with thoracoscopic findings.

Results

US findings were discordant with CT findings regarding consistency, septation, and loculation of effusion in 24/52 patients, with US detecting the findings in 24/24 patients. None of these findings was detectable on CT. US was superior to CT in detection of diaphragmatic nodules (16/52, 3/52, respectively). US findings affected MT conduct in 20/52 cases and outcome in 5/40 cases, and they were consistent with MT findings in 39/40 cases; US and CT missed septation in one case. US findings were concordant with CT findings regarding site and size of effusion and pleural masses, sizable nodules, and thickening. US missed discrete small parietal nodules in 10/52, consolidation in 2/52, mediastinal lymphadenopathy in 6/52, and mediastinal shift in 42/52 cases. CXR could identify mediastinal shift but none of other CT findings were missed by US. None of US-missed abnormalities directly altered MT management.

Conclusion

US identifies more explicitly the imaging information relevant to MT compared with chest CT. Pre-MT imaging workup can be limited to CXR and US, reserving chest CT for cases in which US is technically unrevealing.

References

  1. Rahman NM, Ali NJ, Brown G, Chapman SJ, Davies RJ, Downer NJ, et al. Local anaesthetic thoracoscopy: British Thoracic Society Pleural Disease Guideline 2010. Thorax 2010; 65:ii54–ii60.

    PubMed  Google Scholar 

  2. Kim OH, Kim WS, Kim MJ, Jung JY, Suh JH. US in the diagnosis of pediatric chest diseases. RadioGraphics 2000; 20:653–671.

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  4. Rocco M, Carbone I, Morelli A, Bertoletti L, Rossi S, Vitale M, et al. Diagnostic accuracy of bedside ultrasonography in the ICU: feasibility of detecting pulmonary effusion and lung contusion in patients on respiratory support after severe blunt thoracic trauma. Acta Anaesthesiol Scand 2008; 52:776–784.

    Article  CAS  Google Scholar 

  5. Balik M, Plasil P, Waldauf P, Pazout J; Fric M; Otahal M, Pachl J. Ultrasound estimation of volume of pleural fluid in mechanically ventilated patients. Intensive Care Med 2006; 32:318–321.

    Article  CAS  Google Scholar 

  6. Hersh CP, Feller-Kopman D, Wahidi M, Garland R, Herth F, Ernst A. Ultrasound guidance for medical thoracoscopy: a novel approach. Respiration 2003; 70:299–301.

    Article  Google Scholar 

  7. Medford AR, Agrawal S, Bennett JA, Free CM, Entwisle JJ. Thoracic ultrasound prior to medical thoracoscopy improves pleural access and predicts fibrous septation. Respirology 2010; 15:804–808.

    Article  Google Scholar 

  8. 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 

  9. Jeong JY, Park HJ, Shin JS, Jo WM, Lee IS. Ultrasound for detecting pleural adhesion before video-assisted thoracic surgery. Korean J Thorac Cardiovasc Surg 2010; 43:399–403.

    Article  Google Scholar 

  10. Cassanelli N, Caroli G, Dolci G, Dell’Amore A, Luciano G, Bini A, Stella F. Accuracy of transthoracic ultrasound for the detection of pleural adhesions. Eur J Cardiothorac Surg 2012; 42:813–818.

    Article  Google Scholar 

  11. Mason A, Miller B, Krasna M, White CS. Accuracy of CT for the detection of pleural adhesions: correlation with video-assisted thoracoscopic surgery. Chest 1999; 115:423–427.

    Article  CAS  Google Scholar 

  12. Calder A, Owens CM. Imaging of parapneumonic pleural effusions and empyema in children. Pediatr Radiol 2009; 39:527–537.

    Article  Google Scholar 

  13. Medford AR, Entwisle JJ. Indications for thoracic ultrasound in chest medicine: an observational study. Postgrad Med J 2010; 86:8–11.

    Article  CAS  Google Scholar 

  14. Qureshi NR, Rahman NM, Gleeson FV. Thoracic ultrasound in the diagnosis of malignant pleural effusion. Thorax 2009; 64:139–143.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Chest, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Magdy Khalil & Haytham Samy Diab MD

  2. Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Ahmed Soliman

  3. Abbasia Chest Hospital, Cairo, Egypt

    Hanan Hosny, Emad Edward, Ehab Thabet, Wael Emara & Hanaa Fayez

Authors
  1. Magdy Khalil
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  2. Haytham Samy Diab MD
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  3. Hanan Hosny
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  4. Emad Edward
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  5. Ehab Thabet
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  6. Wael Emara
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  7. Ahmed Soliman
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  8. Hanaa Fayez
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Corresponding author

Correspondence to Haytham Samy Diab MD.

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Khalil, M., Diab, H.S., Hosny, H. et al. Chest ultrasound versus chest computed tomography for imaging assessment before medical thoracoscopy. Egypt J Bronchol 8, 149–152 (2014). https://doi.org/10.4103/1687-8426.145714

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  • DOI: https://doi.org/10.4103/1687-8426.145714

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