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Role of ultrasonography in the diagnosis of pleural effusion

Abstract

Background

Transthoracic ultrasonography (TUS) represents a useful diagnostic tool in the management of pleural diseases. It is the best method for guiding interventional procedures in the pleural space.

Objectives

The aim of this study was to detect the role of ultrasonography (US) in the diagnosis and management of pleural effusion in comparison with computed tomography (CT).

Patients and methods

Patients with suspected clinical and radiological evidence of pleural effusion were included. Routine laboratory investigations, chest radiography, CT of the chest, TUS, and thoracentesis with biochemical, bacteriological, and cytological examination of pleural fluid were carried out for all patients, and medical thoracoscopy and US-assisted interventions were carried out whenever needed.

Results

Eighty-four patients were included in the study. Male patients represented 56% (47 cases), whereas female patients constituted 44% (37 cases); their mean age was 51.21±14.1 years (range: 14–80 years). Seventy-three (86.9%) cases had exudative effusions; inflammatory causes (n=33) and malignancy (n=31) were the most common. TUS was equal to CT in the detection of pleural effusion, pleural thickening, hydropneumothorax, pleural nodule, and consolidation. Moreover, US was better than chest radiography in the detection of pleural thickening, encysted pleural effusion, pleural mass, and consolidation. US was better than CT in the detection of septations (n=30 vs. 5). However, CT was better than US in the detection of loculation (n=28 vs. 17) and pulmonary mass (n=8 vs. 4). Thorcoscopy was performed for nine patients, and was better than US and CT in the detection of pleural nodules.

Conclusion

TUS is an efficient, quick, inexpensive, radiationfree method for the evaluation of pleural diseases.

References

  1. Parmasivam E, Bodenham A. Pleural fluid collections in critically care. Respirology 2007; 7:10–15.

    Google Scholar 

  2. Xirouchaki N, Magkanas E, Vaporidi K, Kondili E, Plataki M, Patrianakos A, et al. Lung ultrasound in critically ill patients: comparison with bed side chest radiography. Intensive Care Med 2011; 37:1488–1493.

    Article  Google Scholar 

  3. Celland C, Mahesh B, Ratnatunga C. Recurrent fibrous tumor of the pleura. Ann Thora Surg 2006; 82:342–345.

    Article  Google Scholar 

  4. Volpicelli G, Elbarbary M, Blaivas M, Lichtenstein DA, Mathis G, Kirkpatrick AW, et al. International evidence-based recommendations for point-ofcare lung ultrasound. Intensive Care Med 2012; 38:577–591.

    Article  Google Scholar 

  5. Mayo PH, Doelken P. Pleural ultrasonography. Clin Chest Med 2006; 27:215–217.

    Article  Google Scholar 

  6. Cardieri JMA, Rodrigues JC. Role of ultrasound in the assessment of pleural effusion. 2nd ed. São Paulo: Sarvier; 1999. pp. 286–288.

  7. Diacon AH, Brutsche MH, Solèr M. Accuracy of pleural puncture sites: a prospective comparison of clinical examination with controversy: closed needle pleural biopsy or thorcoscopy − which first? Respirology 2011; 16:738–746.

    Article  Google Scholar 

  8. Metintas M, Ak G, Dundar E, Yildirim H, Ozkan R, Kurt E, et al. Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial. Chest 2010; 137:1362–1368.

    Article  Google Scholar 

  9. Koegelenberg C, Bolliger C, Diacon A. Transthoracic ultrasound of chest wall, pleura and the peripheral lung. In: Bolliger CT, Herth FJF, Mayo PH, Miyazawa Kawasaki T, Beamis JF, editors. Clincal chest ultrasound. Vol. 37. Karger; 2009: pp. 22–33.

  10. Light RW. Pleural effusions. N Engl J Med 2002; 346:1971–1977.

    Article  Google Scholar 

  11. Koegelenberg C, Bolliger CT, Irusen EM, Wright CA, Louw M, Schubert PT, Diacon AH. The diagnostic yield and safety of ultrasound − assisted transthoracic fine needle aspiration of drowned lung. Respiration 2011; 81:26–31.

    Article  Google Scholar 

  12. Zanobetti M, Claudio P, Riccardo P. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Egypt J Chest Dis Tuberc 2011; 139:1140–1147.

    Google Scholar 

  13. Kalokairinou-Motogna M, Maratou K, Paianid I, Soldatos T, Antipa E, Tsikkini A, et al. Application of color Doppler ultrasound in the study of small pleural effusion. Med Ultrason 2010; 12:12–16.

    PubMed  Google Scholar 

  14. Bediwy AS, Badawy ME, Salama AA, Zayed HA. The use of multi-detector computed tomography and ultrasonography for evaluation of pleural lesions. Egypt J Chest Dis Tuberc 2014; 64:161–168.

    Article  Google Scholar 

  15. Helala LA, Madkour A, Osman NM, Hetta WM, Hakim I. Role of ultrasound in diagnosis and treatment of pleural diseases in respiratory intensive care unit. Egypt J Bronchol 2015; 9:79–79.

    Google Scholar 

  16. Abu-Youssef H, Kamel K, Selim S, El-Deen SM. Study of the added value of transthoracic ultrasound in staging of lung cancer. Egypt J Chest Dis Tuberc 2014; 63:1025–1034.

    Article  Google Scholar 

  17. 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 

  18. Khalil M, Diab H, Hosny H, Edward E, Thabet E, Emara W, et al. Chest ultrasound versus chest computed tomography for imaging assessment before medical thoracoscopy. Egypt J Bronchol 2014; 8:149–152.

    Article  Google Scholar 

  19. Müller NL. Imaging of the pleura. Radiology 1993; 186:297–309.

    Article  Google Scholar 

Download references

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Correspondence to Hoda A. Eid.

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Ahmed, E.S., Abou Bakr, S.M., Eid, H.A. et al. Role of ultrasonography in the diagnosis of pleural effusion. Egypt J Bronchol 11, 120–127 (2017). https://doi.org/10.4103/1687-8426.203797

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