Role of pleural ultrasonographic diagnosis in treatment planning: A study of 3831 cases

Abstract

Background: Pleural effusions are suspected by physical examination and suggested by X-ray chest. Pleural
aspiration is considered next to x-ray chest. If fluid is aspirated, it is dealt according to the guide-line. If no fluid
is found, then next possibility is considered. Chest ultrasound has appeared as an invaluable modality for the
assessment and management of pleuro-pulmonary disorders.
Objectives: To evaluate the usefulness of trans-thoracic ultrasonography for diagnosis and planning the
management of pleuro-pulmonary disorders.
Patients and methods: This retrospective study included 3831 consecutive cases, scanned at OPD of Gulab
Devi Chest Hospital, Lahore from October 2016 till February 2018. The undiagnosed cases suggestive of
having pleural effusion on chest x-ray (CXR) were included. The records of the patients were retrieved,
ultrasonographic findings and final diagnosis were recorded. Results were tabulated and statistical analysis was
performed using SPSS 16. Categorical data was presented as percentage and quantitative data was expressed as
mean with standard deviation.
Results: Pleural effusions were found in 2058/3831 (53.71%) cases; 915 (23.88%) with normal pleurae, 27
(0.70%) collapse, 303 (7.90%) consolidation, 366 (9.55%) pleural thickening, 87 (2.27%) pleuro-phrenic
adhesions and the diagnosis of mass lesion was made in 27 (0.7%) patients. It eliminated the need of pleural
aspiration in 1773 (46.28%) cases by ruling out pleural effusion in which attempted pleural aspiration and
organ puncture was inevitable otherwise.
Conclusion: Trans-thoracic ultrasound is extremely useful for diagnosing and planning management for
suggested pleuro-pulmonary disorders.