Sensitivity of chest ultrasound in the detection of pneumonia in children

Le résumé fourni par la source

Pneumonia is a major cause of hospitalisation in children. Chest x-ray represents the gold-standard method for the detection of pneumonia for more than a century. However, some recent studies showed good sensitivity of the chest ultrasound for the detection of pneumonia. The aim of our study was to compare the sensitivity of ultrasound and chest x-ray for the detection of community-acquired pneumonia in children. We included 54 otherwise healthy children with signs or symptoms of pneumonia who had pulmonary infiltrates detected with chest x-ray and/or ultrasound, both performed in all patients. Number and type of infiltrates and the presence of pleural effusion was recorded. Sensitivity of ultrasound and chest x-ray was compared with McNemar chi-square test. Pneumonia was caused by bacteria, viruses and Mycoplasma pneumoniae in 17, 15 and 22 of patients, respectively. Infiltrates were seen on chest X-ray in 45 out of 54 cases. With the chest ultrasound infiltrates were seen in 53 out of 54 cases. Sensitivity of the chest ultrasound for the detection of pneumonia was 98.1%, which is significantly higher than 83.3% sensitivity of the chest x-ray (p=0.03). Bilateral infiltrates were detected with chest x-ray in 4 cases and with ultrasound in 14 cases (p=0.01). Pleural effusion was detected with chest x-ray in 3 cases and with ultrasound in 7 cases (p=0.04). Chest ultrasound is sensitive, safe, and widely available method for the detection of community-acquired pneumonia in children. However, a prospective study on larger sample and standardisation of the investigation and terminology is needed before the implementation of chest ultrasound in everyday clinical practice.

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