Article Text

Original article
Lung imaging during acute chest syndrome in sickle cell disease: computed tomography patterns and diagnostic accuracy of bedside chest radiograph
Free
  1. Armand Mekontso Dessap1,2,3,
  2. Jean-François Deux2,4,
  3. Anoosha Habibi5,
  4. Nour Abidi1,
  5. Bertrand Godeau2,6,
  6. Serge Adnot2,7,
  7. Christian Brun-Buisson1,2,
  8. Alain Rahmouni2,4,
  9. Frederic Galacteros2,5,
  10. Bernard Maitre2,8
  1. 1Service de Réanimation Médicale, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France
  2. 2Faculté de Médecine, Université Paris Est Créteil, Créteil, France
  3. 3INSERM, Unité U955, Créteil, France
  4. 4Service d'Imagerie Médicale, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France
  5. 5AP-HP, Groupe Henri-Mondor Albert-Chenevier, Unité des Maladies du Globule Rouge, Créteil, France
  6. 6Service de Médecine Interne, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France
  7. 7Service de Physiologie-Explorations Fonctionnelles, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France
  8. 8Unité de Pneumologie, AP-HP, Groupe Henri-Mondor Albert-Chenevier, Créteil, France
  1. Correspondence to Professor Armand Mekontso Dessap, Service de Réanimation Médicale, CHU Henri Mondor, 51 Av Mal de Lattre de Tassigny, Créteil, Cedex 94 010, France; armand.dessap{at}hmn.aphp.fr

Abstract

Introduction The lung computed tomography (CT) features of acute chest syndrome (ACS) in sickle cell disease patients is not well described, and the diagnostic performance of bedside chest radiograph (CR) has not been tested. Our objectives were to describe CT features of ACS and evaluate the reproducibility and diagnostic performance of bedside CR.

Methods We screened 127 consecutive patients during 166 ACS episodes and 145 CT scans (in 118 consecutive patients) were included in the study.

Results Among the 145 CT scans, 139 (96%) exhibited a new pulmonary opacity and 84 (58%) exhibited at least one complete lung segment consolidation. Consolidations were predominant as compared with ground-glass opacities and atelectasis. Lung parenchyma was increasingly consolidated from apex to base; the right and left inferior lobes were almost always involved in patients with a new complete lung segment consolidation on CT scan (98% and 95% of cases, respectively). Patients with a new complete lung segment consolidation on CT scan had a more severe presentation and course as compared with others. The sensitivity of bedside CR for the diagnosis of ACS using CT as a reference was good (>85%), whereas the specificity was weak (<60%).

Conclusions ACS more frequently presented on CT as a consolidation pattern, predominating in lung bases. The reproducibility and diagnostic capacity of bedside CR were far from perfect. These findings may help improve the bedside imaging diagnosis of ACS.

  • ARDS
  • Imaging/CT MRI etc
  • Rare lung diseases
View Full Text

Statistics from Altmetric.com

Supplementary materials

  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Files in this Data Supplement:

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Airwaves
    Andrew Bush Ian Pavord