Lung Ultrasonography Versus Chest X-Ray In The Diagnosis Of Pneumonic Consolidation In Hospitalized Children: A Preliminary Single-Center Study

Abstract

Background Pneumonia is a leading cause of mortality among children, particularly below the age of 5 years, with a large burden on the healthcare system. Therefore, rapid, early diagnosis is important using an easy, non-invasive method with minimal radiation exposure. Until now the most used imaging investigation in children with suspected pneumonia is chest X-ray (CXR). Aim To identify the sensitivity, specificity, and accuracy of point-of-care lung ultrasonography (POCUS) in the diagnosis of pneumonic consolidation in hospitalized children compared to CXR as a reference standard. Methods We enrolled children aged from 1 month to 18 years, with clinically diagnosed pneumonia, who were admitted to Mansoura University Children’s Hospital, Egypt during the period from August 2020 to August 2021. CXR and lung ultrasound (LUS) were done for each patient, within 24 hours of each other. The presence of consolidation in both imaging modalities was compared using sensitivity, specificity, and diagnostic accuracy. The agreement between LUS and CXR was evaluated using Cohen’s kappa test. Results A total of 82 children with clinically diagnosed pneumonia were evaluated. From those 46 patients were included. The study revealed a sensitivity of 97.4% for the detection of pneumonic consolidations by LUS and an accuracy of 87%. The agreement between LUS and CXR for consolidation was statistically significant (p< 0.05), with fair strength of agreement. Conclusion Lung ultrasound is a fast, non-invasive, simple method for the evaluation of children with pneumonia. It is as reliable as CXR in the detection of consolidation and can be easily performed at the patient’s bedside.