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Ultrasound Matches X-rays In Finding Child Pneumonia

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Ultrasound is about as accurate as chest X-rays in detecting pneumonia in children, according to research led at Cincinnati Children’s Hospital by Lilliam Ambroggio, PhD, assistant professor of pediatrics at the University of Cincinnati.

Dr. Ambroggio presented her research last week at the 32nd Annual Meeting of the European Society for Paediatric Infectious Diseases. For an abstract, click here and search by author for “Ambroggio.”

The research found that ultrasound was somewhat more sensitive but less specific than a chest X-ray—better at finding actual cases of pneumonia, but with more false positives. All in all, Dr. Ambroggio said, the two modalities were about even:

Ultrasound and chest radiography in our study were statistically equivalent, suggesting the potential for chest ultrasonography to replace chest X-rays in detecting pneumonia in children, particularly in outpatient and resource-limited areas.

She said ultrasound could be particularly useful in developing countries because “the infrastructure needed to perform and interpret a chest ultrasound is much less than what is needed to perform a chest radiograph.”

She was quoted by the Irish news website TheJournal.ie.

CT remains the gold standard for diagnosing pneumonia in children. However, as the study abstract notes, “its expense, availability, and radiation limit its use.” So Dr. Ambroggio and her team looked at 37 patients, ranging in age from 3 months to 18 years, who had received both chest ultrasound and chest X-rays. Four radiologists who did not know the patients’ clinical diagnoses read the results.

The researchers determined the accuracy of ultrasound and X-rays by comparing them to CT, when available (as was the case for 13 of the children), or by estimating the sensitivity and specificity from the full data set.

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A concussion law meant to protect children with sports injuries may be leading to unnecessary CT head scans—and radiation exposure. For details, see our Facebook page.

Related CME seminar (up to 11 AMA PRA Category 1 credits™): ALARA – CT (As Low As Reasonably Achievable) (all new; just released)

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