Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia.

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Critical Ultrasound Journal Pub Date : 2017-12-01 Epub Date: 2017-02-27 DOI:10.1186/s13089-017-0059-y
Saeed Ali Alzahrani, Majid Abdulatief Al-Salamah, Wedad Hussain Al-Madani, Mahmoud A Elbarbary
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引用次数: 114

Abstract

Background: Physicians are increasingly using point of care lung ultrasound (LUS) for diagnosing pneumonia, especially in critical situations as it represents relatively easy and immediately available tool. They also used it in many associated pathological conditions such as consolidation, pleural effusion, and interstitial syndrome with some reports of more accuracy than chest X-ray. This systematic review and meta-analysis are aimed to estimate the pooled diagnostic accuracy of ultrasound for the diagnosis of pneumonia versus the standard chest radiological imaging.

Methods and main results: A systematic literature search was conducted for all published studies comparing the diagnostic accuracy of LUS against a reference Chest radiological exam (C X-ray or Chest computed Tomography CT scan), combined with clinical criteria for pneumonia in all age groups. Eligible studies were required to have a Chest X-ray and/or CT scan at the time of clinical evaluation. The authors extracted qualitative and quantitative information from eligible studies, and calculated pooled sensitivity and specificity and pooled positive/negative likelihood ratios (LR). Twenty studies containing 2513 subjects were included in this meta-analysis. The pooled estimates for lung ultrasound in the diagnosis of pneumonia were, respectively, as follows: Overall pooled sensitivity and specificity for diagnosis of pneumonia by lung ultrasound were 0.85 (0.84-0.87) and 0.93 (0.92-0.95), respectively. Overall pooled positive and negative LRs were 11.05 (3.76-32.50) and 0.08 (0.04-0.15), pooled diagnostic Odds ratio was 173.64 (38.79-777.35), and area under the pooled ROC (AUC for SROC) was 0.978.

Conclusion: Point of care lung ultrasound is an accurate tool for the diagnosis of pneumonia. Considering being easy, readily availability, low cost, and free from radiological hazards, it can be considered as important diagnostic strategy in this condition.

Abstract Image

Abstract Image

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超声与影像学诊断肺炎的系统回顾与荟萃分析。
背景:医生越来越多地使用肺超声(LUS)诊断肺炎,特别是在危急情况下,因为它是相对容易和立即可用的工具。他们也将其用于许多相关的病理情况,如实变、胸腔积液和间质综合征,有些报告比胸部x线检查更准确。本系统综述和荟萃分析旨在评估超声诊断肺炎与标准胸部放射成像的综合诊断准确性。方法和主要结果:对所有已发表的研究进行了系统的文献检索,比较LUS与参考胸部放射检查(C线或胸部计算机断层扫描CT扫描)的诊断准确性,并结合所有年龄组肺炎的临床标准。符合条件的研究要求在临床评估时进行胸部x线和/或CT扫描。作者从符合条件的研究中提取定性和定量信息,并计算合并敏感性和特异性以及合并阳性/阴性似然比(LR)。本荟萃分析纳入了20项研究,共包含2513名受试者。肺超声诊断肺炎的综合估计分别如下:肺超声诊断肺炎的总体综合敏感性为0.85(0.84-0.87),特异性为0.93(0.92-0.95)。总合并阳性和阴性LRs分别为11.05(3.76 ~ 32.50)和0.08(0.04 ~ 0.15),合并诊断优势比为173.64(38.79 ~ 777.35),合并ROC下面积(SROC的AUC)为0.978。结论:护理点肺超声是诊断肺炎的准确工具。由于其简便、易得、成本低、无放射性危害等优点,可作为本病的重要诊断策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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