Evaluation of Chest Ultrasound in Early Detection and Follow up of Pneumonia in Comparison with CT Chest

Abstract

Pneumonia is considered a major healthcare and economic problem with a considerable effect on morbidity and mortality worldwide. An adequate treatment is reliant on early diagnosis of pneumonia, yet the diagnosis is not always clear at presentation to the emergency department. The current imaging modalities used to diagnose pneumonia include chest x-ray and CT. Chest x-ray is the main imaging approach in many settings, and is easier to perform; however limitations for its use exist. Chest CT scan, considered the gold-standard imaging approach for pneumonia, has its own limitations. Ultrasonography is a fast and non-invasive investigation. Lung ultrasound has recently been shown to be highly effective in evaluating pulmonary conditions such as pneumonia and pneumothorax. The use of Lung ultrasound has gained popularity in Intensive care units and emergency departments in the last decade, and has become increasingly recognized as a potentially useful diagnostic approach for pneumonia. At present, the diagnosis of pneumonia via bedside ultrasonography mainly depends on detecting consolidation. However, pneumonia patients do not always have consolidation, but may have interstitial pneumonia or diffuse pulmonary infiltrations. Even if consolidation is not detected, other abnormalities could be found by ultrasonography, such as focal interstitial pattern, pleural-line abnormalities and subpleural lesions. To date, only a few studies have investigated the use of lung ultrasound in the diagnosis of pneumonia in the emergency department or ICU.