Pneumonias in children - Comparison of lung ultrasonography findings with chest X-rays

Abstract

The aim of the study was to compare lung ultrasonography with chest X-ray findings in children with clinical suspicion of pneumonia and to investigate the accuracy of lung ultrasonography and its value in patient management and in reducing the number of chest X-rays. This prospective study included 52 patients (2 months to 15 years of age), with suspected pneumonia and clinically indicated chest X-rays. In each patient, chest X-rays and prior to it lung ultrasonography examination were performed and their findings compared. Some patients also had follow-up lung ultrasonography and chest X-ray examinations compared. Each hemithorax was evaluated and compared separately. For lung ultrasonography examinations, a combined transthoracic-transabdominal approach was used. The ultrasonography characteristics of pneumonia were determined. Also, the impact of lung ultrasonography on the patient management was analyzed. Comparison between chest X-ray and lung ultrasonography findings was performed in 134 hemithoraces. Fifty-four of them were negative for pneumonia. In the rest of 80 hemithoraces, lung ultrasonography showed a pneumonia-positive fi nding, while chest X-ray were positive in 74 hemithoraces. In 11 of 43 (25.6%) children with pneumonia-positivefi nding, new information gained from sonography affected the course of therapy. Ultrasonography fi nding of pneumonia was presented with subpleural consolidation (100%), air bronchogram (92.5%), interstitial/alveolar-interstitial edema (79%), pleural thickening and irregularity (46%), pleural eff usion (41%), and fl uid bronchogram (7.5%). In conclusion, lung ultrasonography might become an important part of the standard diagnostic protocol in the evaluation of pneumonias in children and reduce the number of chest X-ray.