"LUS offers several different applications, especially if chest x-ray is not available (in point-of-care ultrasonography, in emergency units, in a general practitioner practice) or not applicable," said Dr. Angela Reissig, whose findings were published online June 14 in Chest.

"In cases with sonographic evidence of pneumonia, the diagnosis can be established and the therapy can start immediately," Dr. Reissig, from Friedrich-Schiller-University Jena in Germany, told Reuters Health by email.

She and her colleagues sought to determine the accuracy of LUS in diagnosing CAP compared with two-plane chest x-ray and, when x-ray was negative or equivocal, with low-dose CT.

The study population included 362 patients with clinically suspected CAP who underwent LUS and chest x-ray. Sixty-three patients underwent low-dose CT.

LUS correctly diagnosed CAP in 211 of 226 patients with confirmed CAP, for a sensitivity of 93.4%. Sonographic signs of pneumonia were lacking in 127 of 130 patients without CAP, for a specificity of 97.7%.

Chest x-ray alone was slightly less sensitive (199/215, 92.6%) and slightly more specific (122/122, 100%) than LUS for diagnosing CAP.

Twenty-six cases of LUS-detected CAP were missed or equivocal by x-ray, whereas 14 cases of x-ray-detected CAP were missed by LUS.

Sonography also proved useful for documenting disease remission, and results of follow-up LUS were concordant with follow-up x-rays in 85 (75.6%) patients.

"About 8% of pneumonic lesions are not detectable by LUS," the researchers write. "Therefore, an inconspicuous LUS does not exclude pneumonia."

"We have shown that it is possible to diagnose and follow-up CAP by LUS with a very good sensitivity and specificity (at least comparable with chest x-ray in two planes)," Dr. Reissig concluded.

By Will Boggs, MD

Source: http://bit.ly/P1kmny

Chest 2012.

Last Updated: 2012-07-11 17:36:07 -0400 (Reuters Health)

Copyright © 2012 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Ultrasound aids imaging of pediatric pneumonia, November 14, 2011

Ultrasound matches CT for complicated pediatric pneumonia, November 20, 2009