Volume 83, Issue 10 (January 2025)
Tehran Univ Med J. 2025, 83(10): 721-729 |
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Aminharati A, Azizoddin S, Enayatrad M, Sabzevari M, Zolfaghari P, Sohrabi M B. Comparison of bedside lung ultrasonography and chest CT scan in the diagnosis of pneumonia in patients with CURB‑65 score >2. Tehran Univ Med J. 2025; 83 (10) :721-729
URL: http://tumj.tums.ac.ir/article-1-13883-en.html
URL: http://tumj.tums.ac.ir/article-1-13883-en.html
Azam Aminharati1, Shima Azizoddin *2, Mostafa Enayatrad3, Mozhghan Sabzevari1, Pouneh Zolfaghari4, Mohammad Bagher Sohrabi5
1- Department of Emergency Medicine, Imam Hossain Center for Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran.
2- Department of Emergency Medicine, Imam Hossain Center for Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran. ,shm_azn@yahoo.com
3- Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
4- Vice-Chancellery of Health, Shahroud University of Medical Sciences, Shahroud, Iran.
5- Clinical Research Development Unit Imam, Hossain Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
2- Department of Emergency Medicine, Imam Hossain Center for Education, Research and Treatment, Shahroud University of Medical Sciences, Shahroud, Iran. ,
3- Clinical Research Development Unit, Bahar Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
4- Vice-Chancellery of Health, Shahroud University of Medical Sciences, Shahroud, Iran.
5- Clinical Research Development Unit Imam, Hossain Hospital, Shahroud University of Medical Sciences, Shahroud, Iran.
Abstract: (24 Views)
Background: Pneumonia is one of the most common causes of morbidity and mortality, particularly among individuals older than 65 years, and its early diagnosis can improve patients’ prognosis. Imaging modalities play an important role in the diagnosis of this disease, and recently the role of lung ultrasonography in this regard has been highlighted. The present study was conducted to compare bedside lung ultrasonography with chest Computed Tomography (CT) scan in the diagnosis of pneumonia in patients with a CURB‑65 score greater than 2.
Methods: This cross‑sectional study was conducted on 136 patients suspected of pneumonia who were referred to Imam Hossein Hospital in Shahroud, Iran between April 2021 and March 2023. All eligible patients underwent both lung ultrasound and chest CT. The ultrasound findings were then compared with chest CT results (reference standard). Diagnostic indices including sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and diagnostic accuracy were calculated.
Results: Among the 136 patients studied, 72 (52.7%) were male, and the mean age of the patients was 72.1±14.5 years. Diagnostic findings on ultrasound indicated that among patients with positive ultrasound results, B-line and A-line patterns were observed in 88 (64.7%) and 89 (65.4%) patients, respectively; both findings were significantly associated with the ultrasound-based diagnosis (P=0.001). Additionally, air bronchograms were identified in 9 (6.6%) patients, which also demonstrated a significant association with the ultrasound findings (P=0.049). The sensitivity, specificity, PPV, NPV, and area under the curve for lung ultrasonography were 67.6%, 6.7%, 85.6%, 2.7%, and 37.6%, respectively.
Conclusion: Lung ultrasonography demonstrated very low diagnostic accuracy in detecting pneumonia compared with chest CT scan and therefore cannot be considered a reliable tool for ruling out pneumonia. In cases where there is clinical suspicion of pneumonia, performing a chest CT scan is recommended as the preferred diagnostic modality.
Methods: This cross‑sectional study was conducted on 136 patients suspected of pneumonia who were referred to Imam Hossein Hospital in Shahroud, Iran between April 2021 and March 2023. All eligible patients underwent both lung ultrasound and chest CT. The ultrasound findings were then compared with chest CT results (reference standard). Diagnostic indices including sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and diagnostic accuracy were calculated.
Results: Among the 136 patients studied, 72 (52.7%) were male, and the mean age of the patients was 72.1±14.5 years. Diagnostic findings on ultrasound indicated that among patients with positive ultrasound results, B-line and A-line patterns were observed in 88 (64.7%) and 89 (65.4%) patients, respectively; both findings were significantly associated with the ultrasound-based diagnosis (P=0.001). Additionally, air bronchograms were identified in 9 (6.6%) patients, which also demonstrated a significant association with the ultrasound findings (P=0.049). The sensitivity, specificity, PPV, NPV, and area under the curve for lung ultrasonography were 67.6%, 6.7%, 85.6%, 2.7%, and 37.6%, respectively.
Conclusion: Lung ultrasonography demonstrated very low diagnostic accuracy in detecting pneumonia compared with chest CT scan and therefore cannot be considered a reliable tool for ruling out pneumonia. In cases where there is clinical suspicion of pneumonia, performing a chest CT scan is recommended as the preferred diagnostic modality.
Type of Study: Original Article |
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