Diagnostic Accuracy of Lung Ultrasound in Diagnosis of Pneumonia in Children using Chest X-RAY as Gold Standard
DOI:
https://doi.org/10.51253/pafmj.v73i6.8785Keywords:
Chest radiograph, Paediatric pneumonia, UltrasonographyAbstract
Objective: To determine the diagnostic accuracy of lung ultrasound (LUS) in the diagnosis of pneumonia in children using
chest x-ray as the gold standard.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Radiology, Combined Military Hospital, Sialkot Pakistan, from Feb to Aug 2021
Methodology: All patients underwent clinical examination, chest radiograph (anterior-posterior view), lung ultrasound and
blood sample analysis in the first 24 hours after admission. A pre-specified hospital radiologist carried out a lung ultrasound. The examination was performed with the patient sitting upright or supine. The presence of pneumonia on x-ray and USG were recorded. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of lung ultrasound in the diagnosis of pneumonia by taking chest x-ray as the gold standard was calculated in all the study participants.
Results: In this study, 262 patients with clinical features of pneumonia were enrolled. The mean age of the study participants was 3.27±2.344 years. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), accuracy and frequency of lung ultrasonography (US) vs chest radiography (CR) in diagnosing pneumonia was 95.28%, 87.5%, 99.59%, 36.84%, 95.04% and 96.95% respectively.
Conclusion: Lung ultrasound emerged as a sensitive diagnostic tool to diagnose pneumonia in children. Sensitivity,
specificity, positive predictive value, and negative predictive value all favoured the use of this modality to diagnose pneumonia in paediatric patients.
Downloads
References
Pereda MA, Chavez MA, Hooper-Miele CC. Lung ultrasound for
the diagnosis of pneumonia in children: a meta-analysis.
Pediatrics 2015; 135(4): 714-722.
https://doi.org/10.1542/peds.2014-2833.
Najgrodzka P, Buda N, Zamojska A, Marciniewicz E,
Lewandowicz-Uszyńska A. Lung Ultrasonography in the
Diagnosis of Pneumonia in Children-A Metaanalysis and a
Review of Pediatric Lung Imaging. Ultrasound Q 2019; 35(2):
-163. https://doi.org/ 10.1097/RUQ.0000000000000411.
Gereige RS, Laufer PM. Pneumonia. Pediatr Rev 2013; 34(10):
-456. https://doi.org/ 10.1542/pir.34-10-438. Erratum in:
Pediatr Rev 2014; 35(1): 29.
Chen IC, Hsu JH, Wu JR, Dai ZK. Updated Guidelines for
Childhood Pneumonia Management: A Promising Role for Lung
Ultrasound. Pediatr Neonatol 2015; 56(5): 363-364.
https://doi.org/10.1016/j.pedneo.2015.03.005.
Mazrani W, McHugh K, Marsden PJ. The radiation burden of
radiological investigations. Arch Dis Child 2007; 92(12): 1127–
https://doi.org/10.1136%2Fadc.2006.101782.
Esposito S, Papa SS, Borzani I. Performance of lung
ultrasonography in children with community-acquired
pneumonia. Ital J Pediatr 2014; 40(3): 37.
https://doi.org/10.1186/1824-7288-40-37.
Ho MC, Ker CR, Hsu JH, Wu JR, Dai ZK, Chen IC, et al.
Usefulness of lung ultrasound in the diagnosis of communityacquired pneumonia in children. Pediatr Neonatol 2015; 56(1):
-45. https://doi.org/10.1016/j.pedneo.2014.03.007.
Diagnostic Accuracy of Lung Ultrasound
Pak Armed Forces Med J 2023; 73(6): 1764
Shah VP, Tunik MG, Tsung JW. Prospective evaluation of pointof-care ultrasonography for the diagnosis of pneumonia in
children and young adults. JAMA Pediatr 2013; 167(2): 119–125.
https://doi.org/10.1001/2013.jamapediatrics.107.
Scheier E, Levick N, Peled J, Balla U. Could It Be Pneumonia?
Lung Ultrasound in Children With Low Clinical Suspicion for
Pneumonia. Pediatr Qual Saf 2020; 5(4): e326.
https://doi.org/10.1097%2Fpq9.0000000000000326.
Hassen M, Toma A, Tesfay M, Degafu E, Bekele S, Ayalew F, et
al. Radiologic Diagnosis and Hospitalization among Children
with Severe Community Acquired Pneumonia: A Prospective
Cohort Study. Biomed Res Int 2019; 2019: 6202405.
https://doi.org/10.1155/2019/6202405.
Johnson J, Kline JA. Intraobserver and interobserver agreement
of the interpretation of pediatric chest radiographs. Emerg
Radiol 2010; 17: 285-290.
https://doi.org/10.1007/s10140-009-0854-2.
Frush DP. Radiation, thoracic imaging, and children: radiation
safety. Radiol Clin North Am 2011; 49(3): 1053-1069.
https://doi.org/10.1016/j.rcl.2011.06.003.
Turner JP, Dankoff J. Thoracic ultrasound. Emerg Med Clin
North Am 2012; 30(3): 451-473.
https://doi.org/10.1016/j.emc.2011.12.003.
Reissig A, Copetti R, Mathis G, Mempel C, Schuler A, Zechner P,
et al. Lung ultrasound in the diagnosis and follow-up of
community-acquired pneumonia: prospective multicentre
diagnostic accuracy study. Chest 2012; 142(1): 965-972.
https://doi.org/10.1378/chest.12-0364.
Reissig A, Kroegel C. Sonographic diagnosis and follow-up of
pneumonia: A prospective study. Respiration 2007; 74(3): 537-
https://doi.org/10.1159/000100427.
Bouhemad B, Liu ZH, Arbelot C, Zhang M, Ferarri F, Le-Guen
M, et al. Ultrasound assessment of antibiotic-induced pulmonary
reaeration in ventilator-associated pneumonia. Crit Care Med
; 38(3): 84-92.
https://doi.org/10.1097/ccm.0b013e3181b08cdb.
Urbankowska E, Krenke K, Drobczyński Ł. Lung ultrasound in
the diagnosis and monitoring of community acquired
pneumonia in children. Respir Med 2015; 109(1): 1207-1212.
https://doi.org/10.1016/j.rmed.2015.06.011.
Pereda MA, Chavez MA, Hooper-Miele CC. Lung ultrasound for
the diagnosis of pneumonia in children: a meta-analysis.
Pediatrics 2015; 135(2): 714-722.
Downloads
Published
Issue
Section
How to Cite
