Talwar Neetu, Manik Lucky, Chugh Krishan
Division of Pediatric Pulmonology, Fortis Memorial Research Institute, Gurugram, Haryana, India.
Lung India. 2022 May-Jun;39(3):267-273. doi: 10.4103/lungindia.lungindia_284_21.
In childhood pneumonia, pediatric lung ultrasound (PLUS) is a very sensitive and specific diagnostic alternative to chest X-ray (CXR). However, there is a paucity of literature on this in India. We set out to compare the diagnostic accuracy of PLUS and CXR in hospitalized children with community-acquired pneumonia (CAP).
Prospective, observational study (June 2017-September 2019) at a tertiary care hospital.
Hospitalized children of CAP (3 months-18 years) were included after taking informed, written consent. Hemodynamic instability, asthma, cystic fibrosis, congenital heart disease, immunodeficiency, and malignancy cases were excluded. CXR (frontal view) and PLUS were done within 6 h of each other and within 24 h of hospitalization. Statistical analysis was performed using SPSS software version 25.
Out of 612 consecutive, hospitalized respiratory cases, 261 were recruited. CAP was diagnosed clinically in 148 (56.7%) patients [95 boys (64.19%), mean age in years ± SD: 4.31 ± 4.41]. Abnormal PLUS was present in 141 (95.27%) and abnormal CXR in 128 (86.48%) patients. In radiologically diagnosed pneumonia, PLUS was detected in 123 [123/128 (96.09%)] children, and when CXR was normal, PLUS was abnormal in 18 [18/20 (90%)]. PLUS showed a sensitivity of 95.27% (95%CI: 90.50-98.08) and a specificity of 92.90% (95%CI: 86.53-96.89). CXR showed a sensitivity of 86.49% (95%CI: 79.9-91.55) and a specificity of 90.27% (95%CI: 83.25-95.04).
PLUS is a sensitive, specific test and can be considered as the preferred investigation before CXR in children hospitalized with CAP.
在儿童肺炎中，儿科肺部超声（PLUS）是胸部X线（CXR）一种非常敏感且特异的诊断替代方法。然而，印度关于这方面的文献较少。我们着手比较PLUS和CXR对社区获得性肺炎（CAP）住院儿童的诊断准确性。
在一家三级护理医院进行的前瞻性观察研究（2017年6月 - 2019年9月）。
在获得知情书面同意后，纳入CAP（3个月至18岁）的住院儿童。排除血流动力学不稳定、哮喘、囊性纤维化、先天性心脏病、免疫缺陷和恶性肿瘤病例。CXR（正位片）和PLUS在彼此6小时内且住院24小时内完成。使用SPSS软件25版进行统计分析。
在612例连续住院的呼吸道病例中，招募了261例。148例（56.7%）患者临床诊断为CAP [95名男孩（64.19%），平均年龄（岁）±标准差：4.31 ± 4.41]。141例（95.27%）患者PLUS异常，128例（86.48%）患者CXR异常。在放射学诊断的肺炎中，123例[123/128（96.09%）]儿童检测到PLUS，当CXR正常时，18例[18/（90%）]儿童PLUS异常。PLUS的敏感性为95.27%（95%CI：90. – 98.08），特异性为92.90%（95%CI：86.53 – 96.89）。CXR的敏感性为86.49%（95%CI：79.9 – 91.55），特异性为90.27%（95%CI：83.25 – 95.04）。
PLUS是一种敏感、特异的检查，可被视为CAP住院儿童在CXR之前的首选检查。
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