Evidence map›Paper›PMID 39352218›Full record

ArticleMultidisciplinary respiratory medicine2024

Clinical utility of bedside Contrast-Enhanced Ultrasound (CEUS) in the diagnosis of pneumonia in elderly patients: Comparison with clinical, -radiological and ultrasound diagnosis.

Francesco Giangregorio, Emilio Mosconi, Maria Grazia Debellis, Stella Provini, Ciro Esposito, Manuela Mendozza, Rita Raccanelli, Luigi Maresca, Sara Cinquini, Francesco Tursi

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Article in Multidisciplinary respiratory medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

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10 authors.

Francesco GiangregorioInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Emilio MosconiInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Maria Grazia DebellisInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Stella ProviniInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Ciro EspositoInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Manuela MendozzaInternal Medicine Department, Codogno Hospital, Lodi, Italy.
Rita RaccanelliCardiac and Pneumological Rehabilitation Medicine, Codogno Hospital, Lodi, Italy.
Luigi MarescaCardiac and Pneumological Rehabilitation Medicine, Codogno Hospital, Lodi, Italy.
Sara CinquiniCardiac and Pneumological Rehabilitation Medicine, Codogno Hospital, Lodi, Italy.
Francesco TursiCardiac and Pneumological Rehabilitation Medicine, Codogno Hospital, Lodi, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsto measure the clinical impact of contrast-enhanced ultrasound (CEUS) in the diagnosis of -community-acquired pneumonia (CAP), compared to clinical, radiological and ultrasound diagnosis.

methods84 patients (47/37 males/females, mean age:78,57±11,7 Y) with clinical suspicion of pneumonia and with ultrasound findings of peripheral lung lesions, were investigated with CEUS for a better characterization. Final diagnosis of 65 cap was obtained with complete disappearance of symptoms and pulmonary nodule(s); 19 neoplasms: 16 patients performed histologically with bronchoscopy; 3 refused (non-invasive diagnosis with basal CT-scan and positron emission tomography (PET) with fluorodeoxyglucose (FDG)). Sensitivity, specificity, overall diagnostic accuracy (ODA) (and corresponding AUROC) of clinical-data (CD), chest X-ray(CXR), Lung-ultrasound(LUS), CEUS were calculated with SPSS 26.0 software.

resultsFinal diagnosis: 65 CAP, and 19 chest cancers. 9/65 (13%) patients died, of these 7/9 with older age and heart disease as comorbidity. CD: True-Positive (TP):23, True-negative (TN): 17; False-Positive (FP):2; False-negative (FN):42 (sens:35,4% spec:89,5% ODA10%: PPV:92%, NPV:28,8%) (AUROC±SEauc:0,46±0,076); CXR: TP: 36, TN:14; FP:5, FN:29; (sens: 55,4%; spec: 73,7%; ODA: 32%; PPV:87,5%, NPV:32,66%) (AUROC±SEauc:0,645±0,068). US: TP:59; TN: 14; FP:5, FN:6 (sens: 90,8%, spec: 73,7%, ODA: 84,9%, PPV:92,2%, NPV:70%) (AUROC±SEauc:0,9417±0,024); CEUS: TP: 63; TN: 19; FP:0; FN:2 (sens: 96,9%; spec: 100% ODA: 97,5%; PPV: 100%, NPV:90,5%) (AUROC±SEauc:0,98±0,01).

conclusionsClinical-data and chest X-RAYS are insufficient to obtain a correct diagnosis of CAP in elderly population; US demonstrated a good accuracy to establish CAP, but with a relatively low specificity; in these cases, CEUS is able to give a correct characterization, allowing you to save the need for a chest contrast-enhanced-CT (CECT).

Identifiers

PMID39352218
PMCPMC11482042

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