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Swirling pattern in patients with exudative pleural effusion
Egyptian Journal of Bronchology volume 11, pages 250–254 (2017)
Abstract
Objective
Thoracic ultrasound is the gold-standard method for studying pleural effusions. It is more sensitive than chest radiography or computed tomography.
Aim
The aim of the paper was to determine whether the echogenic swirling pattern identifiable on real-time chest ultrasonographic images is a predictor of malignant pleural effusions.
Design
Medical records of patients undergoing chest ultrasonography in the Chest Department in Kasr Alaini Cairo University Hospital in the period from July 2013 to December 2014 were reviewed retrospectively. Patients with an echogenic swirling pattern in the pleural effusion, or with malignant diseases associated with pleural effusions, whose pleural fluids had been examined cytologically or whose pleural tissues had been examined pathologically, were enrolled in this study. A total of 45 patients were included. Malignant pleural effusions were diagnosed by the presence of malignant cells in the pleural fluid identified by pleural biopsy. The echogenic swirling pattern was defined as numerous echogenic floating particles within the pleural effusion, which swirled in response to respiratory movement or heartbeat.
Results
There was a statistically significant relation between the swirling sign and the diameter, type, and amount of pleural fluid, with P value of 0.001. There was no statistical significance between the swirling sign and each of the diagnosis, whether malignant or nonmalignant, malignant cases either primary or secondary malignancy, and side of effusion.
Conclusion
The presence of the swirling sign is related to the nature and amount of fluid and has no predilection to the diagnosis of the cause of pleural effusion.
References
Chernow B, Sahn SA. Carcinomatous involvement of the pleura: an analysis of 96 patients. Am J Med 1977; 63:695–702.
Meyer PC. Metastatic carcinoma of the pleura. Thorax 1966; 21: 437–443.
American Thoracic Society. Management of malignant pleural effusions. Am J Respir Crit Care Med 2000; 162:1987–2001.
Hirsch JH, Roger JV, Mack LA. Real-time sonography of pleural opacities. AJR Am J Roentgenol 1981; 36:297–301.
Chian CF, Su WL, Soh LH, Yan HC, Perng WC, Wu CP. Echogenic swirling pattern as a predictor of malignant pleural effusion in patients with malignancies. Chest 2004; 126:129–134.
Chan YH. Biostatistics 102: quantitative data – parametric & non-parametric tests. Singapore Med J 2003; 44:391–396.
Chan YH. Biostatistics 103: qualitative data - tests of independence. Singapore Med J 2003; 44:498–503.
Rosenberg ER. Ultrasound in the assessment of pleural densities. Chest 1983; 84:283–285.
Yang PC, Luh KT, Chang DB, Wu HD, Yu CJ, Kuo SH. Value of sonography in determining the nature of pleural effusion: analysis of 320 cases. Am J Roentgenol 1992; 159:29–33.
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Kamel, K., Emam, R.H., Almeldin, A.I. et al. Swirling pattern in patients with exudative pleural effusion. Egypt J Bronchol 11, 250–254 (2017). https://doi.org/10.4103/ejb.ejb_65_16
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DOI: https://doi.org/10.4103/ejb.ejb_65_16