Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 149-152

Chest ultrasound versus chest computed tomography for imaging assessment before medical thoracoscopy

1 Department of Chest, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Abbasia Chest Hospital, Cairo, Egypt
3 Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Correspondence Address:
Haytham Samy Diab
Villa 480, West Golf Area, 5th Settlement, New Cairo City, Cairo, 75667
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-8426.145714

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Background and objective The aim of this work was to assess the concordance between chest ultrasound (US) and chest computed tomography (CT) findings before medical thoracoscopy (MT) and the impact of the findings on the conduct and outcome of MT. Materials and methods The study was conducted prospectively on 52 patients referred for MT. All patients received chest X-ray (CXR), chest US, and chest CT before the procedure. Images were evaluated and findings were correlated with thoracoscopic findings. Results US findings were discordant with CT findings regarding consistency, septation, and loculation of effusion in 24/52 patients, with US detecting the findings in 24/24 patients. None of these findings was detectable on CT. US was superior to CT in detection of diaphragmatic nodules (16/52, 3/52, respectively). US findings affected MT conduct in 20/52 cases and outcome in 5/40 cases, and they were consistent with MT findings in 39/40 cases; US and CT missed septation in one case. US findings were concordant with CT findings regarding site and size of effusion and pleural masses, sizable nodules, and thickening. US missed discrete small parietal nodules in 10/52, consolidation in 2/52, mediastinal lymphadenopathy in 6/52, and mediastinal shift in 42/52 cases. CXR could identify mediastinal shift but none of other CT findings were missed by US. None of US-missed abnormalities directly altered MT management. Conclusion US identifies more explicitly the imaging information relevant to MT compared with chest CT. Pre-MT imaging workup can be limited to CXR and US, reserving chest CT for cases in which US is technically unrevealing.

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