RESUMEN
Chest ultrasound, a diagnostic technique used mainly by radiologists, is useful for managing pleural effusion. Sonography and computed tomography (CT) are complementary, although the former is more accessible to clinicians because it is safe and easy to use and because results are available quickly. We evaluated the utility of chest sonograms in a respiratory medicine unit managed by pneumologists. During the period under study, requests for CT scans to manage complicated pleural effusions decreased as the use of sonograms increased. We conclude that ultrasound imaging is useful in the hands of pneumologists who use the technique to diagnose pleural effusions.
Asunto(s)
Derrame Pleural/diagnóstico por imagen , Enfermedades Torácicas/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía Torácica , Radiología Intervencionista/métodos , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
La ecografía torácica es una técnica diagnóstica útil para el tratamiento del derrame pleural, que es realizada fundamentalmente por radiólogos. La ecografía y la tomografía computarizada son complementarias, si bien la rapidez de los resultados, la inocuidad y la sencillez de manejo hacen de la ecografía la técnica más accesible a los clínicos. En este sentido se ha valorado la utilidad de la ecografía torácica en una unidad de técnicas respiratorias manejada por neumólogos. Durante el período estudiado, la solicitud de tomografía computarizada para el tratamiento de los derrames pleurales complicados ha disminuido, al mismo tiempo que se incrementaban el número de ecografías torácicas realizadas. Concluimos que la ecografía, en manos de neumólogos que realizan procedimientos diagnósticos pleurales, es una herramienta útil (AU)
Asunto(s)
Persona de Mediana Edad , Niño , Adolescente , Anciano de 80 o más Años , Adulto , Anciano , Masculino , Femenino , Humanos , Enfermedades Torácicas , Tomografía Computarizada por Rayos X , Radiografía Torácica , Radiología Intervencionista , Derrame PleuralRESUMEN
This study was conducted to assess the prevalence of eosinophilia in 358 consecutive samples of pleural fluid (all cases corresponded to first thoracentesis), to review the cause of eosinophilic pleural effusions, and to determine whether the presence of eosinophils increases the likelihood of nonmalignant underlying disorders. Eosinophilic pleural effusions were identified in 45 patients (12.6%): malignant underlying conditions were diagnosed in 11 patients (24.4% with eosinophilic effusions) and benign aetiologies were found in 27 patients. Benign aetiologies included uncomplicated paraneumonic effusion in 10 patients, tuberculosis in seven, complicated paraneumonic in five, liver cirrhosis in three, hydronephrosis in one and pulmonary thromboembolism in one. Seven pleural effusions were idiopathic. There was no difference in the prevalence between eosinophilic and noneosinophilic effusions according to the different diagnoses. With parameters of sensitivity, specificity, pretest and post-test probability and positive and negative predictive values for any prevalence figure using the Bayes' theorem and for any value of eosinophils (both in percentage or absolute numbers) in the pleural fluid (receiver operating characteristic curve) an adequate predictor of benign disease was not found. It is concluded that pleural eosinophilia at the initial thoracentesis cannot be considered as a predictor of an underlying benign disorder.
