Mancusi Costantino, Fucile Ilaria, Gargiulo Paola, Mosca Mariangela, Migliaccio Biagio, Basile Christian, Gargiulo Giuseppe, Santoro Ciro, Morisco Carmine, De Luca Nicola, Esposito Giovanni
Emergency Medicine School, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy.
Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy.
Diagnostics (Basel). 2022 Dec 7;12(12):3082. doi: 10.3390/diagnostics12123082.
Background: In the setting of a coronary care unit (CCU), the early detection of pneumonia is of paramount important to prevent severe complications. This study was designed aiming to evaluate the diagnostic accuracy of lung ultrasound (LUS) in the detection of pneumonia and compared with chest X-ray (CXR). Method: We enrolled 110 consecutive patients admitted to the CCU of Federico II University Hospital. Each patient underwent CXR and bedside LUS on admission. The final diagnosis (pneumonia vs. no pneumonia) was established by another clinician reviewing clinical and laboratory data independent of LUS results and possibly prescribing chest contrast-enhanced CT (n = 34). Results: The mean age was 70 ± 11 years old, and 68% were males. Pneumonia was clinically diagnosed in 26 (23%) patients. LUS was positive for pneumonia in 24 patients (sensitivity 92%, specificity 81%). Chest radiography was positive for pneumonia in nine patients (sensitivity 43%, specificity 95%). Using CT scan as a reference, LUS exhibited 92% sensitivity and a specificity of 96%. In ROC curve analysis, the diagnostic accuracy of CXR and LUS for the diagnosis of pneumonia was 0.86 (95% CI 0.77−0.94), which was higher than CXR 0.68 (95% CI 0.55−0.84), p < 0.05. Conclusion: Based on the findings of the present study, the accuracy of LUS in the detection of pneumonia was significantly higher than chest X-ray with comparable sensibility to CT scan.
在冠心病监护病房（CCU）环境中，肺炎的早期检测对于预防严重并发症至关重要。本研究旨在评估肺部超声（LUS）在检测肺炎方面的诊断准确性，并与胸部X线（CXR）进行比较。方法：我们连续纳入了110例入住费德里科二世大学医院CCU的患者。每位患者入院时均接受了CXR和床边LUS检查。最终诊断（肺炎与非肺炎）由另一位临床医生根据独立于LUS结果的临床和实验室数据确定，并可能进行胸部增强CT检查（n = 34）。结果：平均年龄为70±11岁，男性占68%。临床诊断为肺炎的患者有26例（23%）。24例患者的LUS显示肺炎阳性（敏感性92%，特异性81%）。9例患者的胸部X线显示肺炎阳性（敏感性43%，特异性95%）。以CT扫描为参考，LUS的敏感性为92%，特异性为96%。在ROC曲线分析中，CXR和LUS诊断肺炎的诊断准确性为0.86（95%CI 0.77−0.94），高于CXR的0.68（95%CI 0.55−0.84），p<0.05。结论：基于本研究结果，LUS检测肺炎的准确性显著高于胸部X线，其敏感性与CT扫描相当。
