Usefulness of thoracic ultrasound in the assessment of removal of indwelling pleural catheter in patients with malignant pleural effusion.

Autor: Iglesias Heras M; Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca. Spain. Electronic address: miglesiash@saludcastillayleon.es., Juárez Moreno E; Servicio de Neumología, Hospital El Bierzo, Ponferrada, León, Spain., Ortiz de Saracho Bobo J; Servicio de Neumología, Hospital El Bierzo, Ponferrada, León, Spain., Cascón Hernández J; Servicio de Neumología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain., Fernández García-Hierro JM; Servicio de Radiodiagnóstico, Hospital Universitario de Salamanca, Salamanca, Spain., Yagüe Zapatero E; Servicio de Radiodiagnóstico, Hospital El Bierzo, Ponferrada, León, Spain., Cordovilla Pérez R; Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca. Spain.
Jazyk: angličtina
Zdroj: Radiologia [Radiologia (Engl Ed)] 2024 Apr; Vol. 66 Suppl 1, pp. S24-S31. Date of Electronic Publication: 2024 Mar 01.
DOI: 10.1016/j.rxeng.2023.04.008
Abstrakt: Introduction: There are no defined criteria for deciding to remove a non-functioning indwelling pleural catheter (IPC) when lung re-expansion on chest X-ray is incomplete. Chest computed tomography (chest CT) is usually used. The objective of this work is to validate the usefulness of chest ultrasound performed by a pulmonologist and by a radiologist compared to chest CT.
Patients and Methods: Prospective, descriptive, multidisciplinary and multicenter study including patients with malignant pleural effusion and non-functioning IPC without lung reexpansion. Decisions made on the basis of chest ultrasound performed by a pulmonologist, and performed by a radiologist, were compared with chest CT as the gold standard.
Results: 18 patients were analyzed, all of them underwent ultrasound by a pulmonologist and chest CT and in 11 of them also ultrasound by a radiologist. The ultrasound performed by the pulmonologist presents a sensitivity of 60%, specificity of 100%, PPV 100% and NPV 66% in the decision of the correct removal of the IPC. The concordance of both ultrasounds (pulmonologist and radiologist) was 100%, with a kappa index of 1. The 4 discordant cases were those in which the IPC was not located on the ultrasound.
Conclusions: Thoracic ultrasound performed by an expert pulmonologist is a valid and simple tool to determine spontaneous pleurodesis and remove a non-functioning IPC, which would make it possible to avoid chest CT in those cases in which lung reexpansion is observed with ultrasonography.
(Copyright © 2023 SERAM. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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