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 fi ndings 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 fi ndings 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 fi ndings 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-positive fi nding, new information gained from sonography aff ected 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.