[Contrast-enhancend sonography (CEUS) in pneumonia: typical patterns and clinical value - a retrospective study on n = 50 patients].

PURPOSE

To describe contrast-enhanced ultrasound (CEUS) patterns of pneumonia, to characterize CEUS patterns and to determine the clinical value of deviant CEUS patterns.

PATIENTS AND METHODS

N = 50 patients with radiologically diagnosed alveolar pneumonia were investigated by CEUS and retrospectively evaluated. Pulmonary enhancement was differentiated from bronchial arterial enhancement by measurement of time to enhancement from the application of the contrast agent (CA). The echogenicity of the CA enhancement was evaluated (isoechoic/hypoechoic) using the spleen as an "in vivo reference". In addition, the homogeneity of the CA enhancement (homogeneous/ inhomogeneous) was recorded. The patients were divided into two groups according to the CEUS pattern (type 1/type 2) and compared to each other in terms of age, days of hospitalization, comorbidity, rate of complications and the presence of pleural effusion.

RESULTS

The majority showed a type 1 CEUS pattern consisting of a pulmonary arterial supply (92 %), an isoechoic extent of enhancement (74 %) and a homogeneous enhancement (78 %) of the CA in the pulmonary lesions. The only significant difference found between the two groups was the average age.

CONCLUSION

Pneumonia most likely shows a type 1 CEUS pattern consisting of a pulmonary arterial supply, an isoechoic extent of enhancement compared to the spleen and a homogeneous enhancement of the CA in the pulmonary lesions. Prognostic value of a type 2 CEUS pattern (bronchial arterial supply and/or hypoechoic extent of enhancement and/or inhomogeneous enhancement) in pneumonia regarding days of hospitalization, comorbidity, rate of complications and the presence of pleural effusion could not be shown.