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The accuracy of pleural ultrasonography in diagnosing complicated parapneumonic pleural effusions
  1. Philip Z Svigals1,
  2. Amit Chopra2,
  3. James G Ravenel3,
  4. Paul J Nietert4,
  5. John T Huggins1
  1. 1Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Division of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, New York, USA
  3. 3Division of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Correspondence to Dr Philip Z Svigals, Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, Charleston, SC 29425-2503, USA; zachsvigals{at}gmail.com

Abstract

We compared the accuracy of pleural ultrasound versus chest CT versus chest radiograph (CXR) to determine radiographic complexity in predicting a complicated parapneumonic effusion (CPPE) defined by pleural fluid analysis. 66 patients with parapneumonic effusions were identified with complete data. Pleural ultrasound had a sensitivity of 69.2% (95% CI 48.2% to 85.7%) and specificity of 90.0% (95% CI 76.3% to 97.2%). Chest CT had a sensitivity of 76.9% (95% CI 56.3% to 91.0%) and specificity of 65.0% (95% CI 48.3% to 79.4%). CXR had a sensitivity of 61.5% (95% CI 40.6% to 79.8%) and specificity of 60.0% (95% CI 43.3% to 75.1%). Pleural ultrasound appears to be a superior modality to rule in a CPPE when compared with chest CT and CXR.

  • Pleural Disease
  • Imaging/CT MRI etc
  • Pneumonia

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Footnotes

  • Contributors PZS is a contributing author. He was responsible in part for the concept, study design, data collection and analysis for this study. He is a lead author of the manuscript and has had content review and editing input for the manuscript. AC is a contributing author. He is an author of the manuscript and has had content review and editing input for the manuscript. JGR is a contributing author. He is an author of the manuscript and was responsible in part for the analysis for this study. PJN is a contributing author. He is an author of the manuscript and was responsible in part for the analysis for this study. He has had content review and editing input for the manuscript. PJN's time on this project was funded by the National Institutes of Health (NIH), National Center for Advancing Translational Science (grant number UL1TR001450) and the National Institute of General Medical Sciences (grant number U54-GM104941). JTH is the guarantor of the content of this manuscript. He was responsible in part for the concept, study design, data collection and analysis for this study. He is the lead author of the manuscript and has had content review and editing input for the manuscript.

  • Funding PJN has no conflicts of interest. His time on this project was funded by the NIH, National Center for Advancing Translational Science (grant number UL1TR001450) and the National Institute of General Medical Sciences (grant number U54-GM104941).

  • Competing interests None declared.

  • Ethics approval Medical University of South Carolina's Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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