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Lung Ultrasound a Useful Tool to Diagnose Pulmonary Atelectasis in Children Affected by Neuromuscular Disease
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A3659 - Lung Ultrasound a Useful Tool to Diagnose Pulmonary Atelectasis in Children Affected by Neuromuscular Disease
Author Block: N. Ullmann1, B. Papia1, M. D'Andrea2, M. Chiarini1, P. Tomà2, C. Cherchi1, M. Pavone1, R. Cutrera1; 1Respiratory Unit, Academic Department of Pediatrics, Bambino Gesù Children Hospital, Rome, Italy, 2Radiology, Bambino Gesù Children Hospital, Rome, Italy.
Introduction: Neuromuscular diseases are characterized by progressive weakness of voluntary muscles which alters the physiologic respiratory mechanic, determines accumulation of secretions facilitating recurrent pneumonia and atelectasis formation. This condition results in an excess use of imaging exams (chest radiography and CT scan), resulting in frequent exposure to ionizing radiation. Therefore, it is necessary to identify a reproducible, low cost, non-invasive and reliable diagnostic method to avoid the need for continuous imaging examinations.
Material and Methods: Pediatric patients affected by neuromuscular diseases admitted to the Broncopneumology Department for a follow-up assessment or for an acute event were enrolled. In those patients who underwent a chest radiography (Rx) for clinical reasons, a pulmonary ultrasound (PU) was also performed within the following 72 h.
Results: Rx and PU were performed in 27 patients (44% males, mean age: 7.5 years). PU highlighted pulmonary atelectasis in 13/27 cases. In 2 patients PU was not conclusive because of severe scoliosis. Out of the 12 patients with negative PU for atelectasis, in two patients PU described pulmonary thickening, in one of those cases complicated by pleural effusion. Rx described 13/27 cases positive for atelectasis and, between the negative, 1 patient with pneumonia. Considering chest radiography as the gold standard, concordance between the two examinations showed: Sensitivity 100%, Specificity 85,7%; Negative predictive value 100%, Positive predictive value: 86,6%. Moreover, it is important to point out that in 2 cases with atelectasis, the PU also allowed to detect a pleural effusion, not described by RX.
Conclusions: Our results show that PU has an excellent diagnostic reliability versus chest radiography in identifying pulmonary atelectasis in children affected by neuromuscular diseases. This study, although limited by a small population, shows that the PU could be an extremely useful test in the follow-up and diagnosis of pulmonary atelectasis in neuromuscular patients. This data, if confirmed with bigger numbers, will allow a significant reduction in exposure to ionizing radiation for young and fragile patients.
Author Block: N. Ullmann1, B. Papia1, M. D'Andrea2, M. Chiarini1, P. Tomà2, C. Cherchi1, M. Pavone1, R. Cutrera1; 1Respiratory Unit, Academic Department of Pediatrics, Bambino Gesù Children Hospital, Rome, Italy, 2Radiology, Bambino Gesù Children Hospital, Rome, Italy.
Introduction: Neuromuscular diseases are characterized by progressive weakness of voluntary muscles which alters the physiologic respiratory mechanic, determines accumulation of secretions facilitating recurrent pneumonia and atelectasis formation. This condition results in an excess use of imaging exams (chest radiography and CT scan), resulting in frequent exposure to ionizing radiation. Therefore, it is necessary to identify a reproducible, low cost, non-invasive and reliable diagnostic method to avoid the need for continuous imaging examinations.
Material and Methods: Pediatric patients affected by neuromuscular diseases admitted to the Broncopneumology Department for a follow-up assessment or for an acute event were enrolled. In those patients who underwent a chest radiography (Rx) for clinical reasons, a pulmonary ultrasound (PU) was also performed within the following 72 h.
Results: Rx and PU were performed in 27 patients (44% males, mean age: 7.5 years). PU highlighted pulmonary atelectasis in 13/27 cases. In 2 patients PU was not conclusive because of severe scoliosis. Out of the 12 patients with negative PU for atelectasis, in two patients PU described pulmonary thickening, in one of those cases complicated by pleural effusion. Rx described 13/27 cases positive for atelectasis and, between the negative, 1 patient with pneumonia. Considering chest radiography as the gold standard, concordance between the two examinations showed: Sensitivity 100%, Specificity 85,7%; Negative predictive value 100%, Positive predictive value: 86,6%. Moreover, it is important to point out that in 2 cases with atelectasis, the PU also allowed to detect a pleural effusion, not described by RX.
Conclusions: Our results show that PU has an excellent diagnostic reliability versus chest radiography in identifying pulmonary atelectasis in children affected by neuromuscular diseases. This study, although limited by a small population, shows that the PU could be an extremely useful test in the follow-up and diagnosis of pulmonary atelectasis in neuromuscular patients. This data, if confirmed with bigger numbers, will allow a significant reduction in exposure to ionizing radiation for young and fragile patients.
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