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Imaging |

Can Transthoracic Ultrasound (TUS) Differentiate Between Simple and Obstructive Pneumonia?

Safaa Wafy; Aliae Mohamed-Hussein; Gamal Agmy; Randa Ez eldeen,
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Chest Department, Assiut University, Assiut, Egypt


Chest. 2014;146(4_MeetingAbstracts):580A. doi:10.1378/chest.1988868
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Abstract

SESSION TITLE: Ultrasound and Other Imaging Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To describe sonographic features of simple and obustrected pneumonia and discuss the value of TUS in differentiate between both diseases.

METHODS: The study included 25 patients, 18 patients with simple pneumonia and 7 patients with obstructed pneumonia (17 males and 8 females). The main diagnostic sonographic criteria of TUS are defined as follows; Air bronchogram impresses as small air inlet within a consolidation measuring a few millimeters in diameter or as a tree-shaped echogenic structure. A fluid bronchogram represents exudates-packed conducting airway.

RESULTS: The study included 18 patients with simple pneumonia and 7 patients with obstructed pneumonia.The sonographic finding were:positive air bronchogram was recorded in 100% of cases of simple pneumonia and not found in any cases of obstructed pneumonia,fluid bronchogram not found in any cases of simple pneumonia and present in100% of obstructed pneumonia(P value 0.005),oval and rounded shape,irregular shape,sharp well-demarcated,blurred border,homogenous,heterogenous,hypoechoic echopattern were found in(38.9% ,61.1% ,33.3%,66.7%,11.1%,88.9%,100% )of cases of simple pneumonia and in(42.9%,57.1%,28.6%,71.4%,0%,100%,85.7%)of cases of obstructed pneumonia respectively.Pleural effusion was present in 44.4% and 42.9% of cases of simple and obstructed pneumonia respectively.The fluid bronchogram was seen in bronchial obstruction,result from either impacted secretions or a proximal tumor.

CONCLUSIONS: the presence of fluid bronchogram sign in the appropriate clinical context should raise the suspicion of postobstructive pneumonitis.TUS help in distinguishing the central obstructing tumor as a hypoechoic mass from the distal more echogenic consolidation.

CLINICAL IMPLICATIONS: Color Doppler US demonstrates normal or increased flow in the normal vessels of the consolidated lung, and may be helpful in distinguishing simple pneumonia from postobstructive pneumonia.

DISCLOSURE: The following authors have nothing to disclose: Safaa Wafy, Aliae Mohamed-Hussein, Gamal Agmy, Randa Ez eldeen,

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