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Reissig, Angelika; Kroegel, Claus

Sonographic Diagnosis and Follow-Up of Pneumonia: A Prospective Study

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  • Media type: E-Article
  • Title: Sonographic Diagnosis and Follow-Up of Pneumonia: A Prospective Study
  • Contributor: Reissig, Angelika; Kroegel, Claus
  • imprint: S. Karger AG, 2007
  • Published in: Respiration
  • Language: English
  • DOI: 10.1159/000100427
  • ISSN: 0025-7931; 1423-0356
  • Origination:
  • Footnote:
  • Description: <jats:p>&lt;i&gt;Background:&lt;/i&gt; Although transthoracic ultrasound offers several important advantages as diagnostic imaging technique in pleural and pulmonary conditions, its significance for the diagnosis and monitoring of pneumonia has yet to be established. &lt;i&gt;Objectives:&lt;/i&gt; To identify sonographic features associated with pneumonia at admission and during the course of the disease under treatment. &lt;i&gt;Methods:&lt;/i&gt; Thirty patients (12 females, 18 males; median age 65.5 years) with X-ray-proven pneumonia underwent transthoracic sonography (TS) on day 0, between days 1 and 3, 4 and 7, 8 and 14, 15 and 21, and after day 21. TS was assessed according to: number, location, shape, echogenicity, echotexture, echostructure, breath-depending movement, size of pneumonic lesions, bronchoaerogram, fluid bronchogram, superficial fluid alveologram, necrotic areas, vascularity and incidence of local and/or basal pleural effusion. &lt;i&gt;Results:&lt;/i&gt;Thirty-three pneumonic infiltrates were eligible for analysis in 30 patients. In 57% (17/30), the likely pathogenic microorganism was identified. Pneumonia was recognized as a hypoechoic area of varying size (mean size between 33.7 × 9.38 and 91.2 × 45.3 mm) and shape, with irregular and blurred margins along with a nonhomogeneous echotexture. The most characteristic feature was a positive bronchoaerogram (32/33). Sixty-one percent (20/33) revealed basal and 9% (3/33) local effusion. During follow-up, lesions decreased in size or disappeared (30/33) or decreased in number (4/9). The bronchoaerogram became less pronounced (13/32), basal pleural effusion either diminished (7/20) or dissipated (7/20), as did localized effusion (3/3). In 30 cases, the course of pneumonia was comparable using X-ray and TS. &lt;i&gt;Conclusions:&lt;/i&gt; TS is a noninvasive technique for the diagnosis and follow-up of patients with pneumonia.</jats:p>