Chest ultrasound can serve as a viable alternative to chest CT in the evaluation of pediatric patients with complicated pneumonia and parapneumonic effusion (a build-up of fluid between the lung and chest wall), according to a study published in the December issue of the American Journal of Roentgenology.
Pneumonia in the pediatric population is common. Both the diagnosis and therapy of complicated pneumonia is guided by imaging - CT, to date, playing a central role in complicated cases.
In the study, performed at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, N.Y., both chest CT and chest ultrasound were performed on 19 children with complicated pneumonia accompanied by parapneumonic effusion. "Our results showed that chest CT did not provide additional clinically useful information that was not also seen on chest ultrasound," said Terry L. Levin, M.D., lead author of the study.
"No consensus exists on the optimal technique for imaging complicated pneumonia in children. Although chest CT allows rapid image acquisition, the rising use of CT in the pediatric population raises the concern of an increasing ionizing radiation burden," said Levin. "The benefits of chest ultrasound over chest CT include its portability, absence of need for patient sedation, and that ultrasound does not use ionizing radiation," she said.
"As a result of our study, we suggest that the evaluation of children with complicated pneumonia include chest radiography and chest ultrasound. Chest CT may be reserved for patients in whom chest ultrasound is technically difficult or discrepant with the clinical findings," said Levin.
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