RT Journal Article
SR Electronic
T1 Lung imaging during acute chest syndrome in sickle cell disease: computed tomography patterns and diagnostic accuracy of bedside chest radiograph
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 144
OP 151
DO 10.1136/thoraxjnl-2013-203775
VO 69
IS 2
A1 Armand Mekontso Dessap
A1 Jean-François Deux
A1 Anoosha Habibi
A1 Nour Abidi
A1 Bertrand Godeau
A1 Serge Adnot
A1 Christian Brun-Buisson
A1 Alain Rahmouni
A1 Frederic Galacteros
A1 Bernard Maitre
YR 2014
UL http://thorax.bmj.com/content/69/2/144.abstract
AB 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.