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Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19

BACKGROUND: Lung ultrasound (LUS) and chest radiography (CXR) are the most used chest imaging tools in the early diagnosis of COVID-19 associated pneumonia. However, the relationship between LUS and CXR is not clearly defined. The aim of our study was to describe the comparison between LUS interpret...

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Autores principales: Volpicelli, Giovanni, Cardinale, Luciano, Fraccalini, Thomas, Calandri, Marco, Piatti, Clara, Geninatti, Carlotta, Stranieri, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907795/
https://www.ncbi.nlm.nih.gov/pubmed/33635443
http://dx.doi.org/10.1186/s13089-021-00215-9
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author Volpicelli, Giovanni
Cardinale, Luciano
Fraccalini, Thomas
Calandri, Marco
Piatti, Clara
Geninatti, Carlotta
Stranieri, Giuseppe
author_facet Volpicelli, Giovanni
Cardinale, Luciano
Fraccalini, Thomas
Calandri, Marco
Piatti, Clara
Geninatti, Carlotta
Stranieri, Giuseppe
author_sort Volpicelli, Giovanni
collection PubMed
description BACKGROUND: Lung ultrasound (LUS) and chest radiography (CXR) are the most used chest imaging tools in the early diagnosis of COVID-19 associated pneumonia. However, the relationship between LUS and CXR is not clearly defined. The aim of our study was to describe the comparison between LUS interpretation and CXR readings in the first approach to patients suspected of COVID-19. METHODS: In the time of the first COVID-19 pandemic surge, we prospectively evaluated adult patients presenting to an emergency department complaining of symptoms raising suspicion of COVID-19. Patients were studied by LUS and only those performing also CXR were analyzed. All the patients performed viral reverse transcriptase-polymerase chain reaction (RT-PCR). LUS studies were classified in 4 categories of probabilities, based on the presence of typical or alternative signs of COVID-19-associated interstitial pneumonia. Accordingly, the CXR readings were retrospectively adapted by 2 experts in 4 categories following the standard language that describes the computed tomography (CT) findings. Patients were divided in two groups, based on the agreement of the LUS and CXR categories. Results were also compared to RT-PCR and, when available, to CT studies. RESULTS: We analyzed 139 cases (55 women, mean age 59.1 ± 15.5 years old). The LUS vs CXR results disagreed in 60 (43.2%) cases. RT-PCR was positive in 88 (63.3%) cases. In 45 cases, a CT scan was also performed and only 4 disagreed with LUS interpretation versus 24 in the comparison between CT and CXR. In 18 cases, LUS detected signs of COVID-19 pneumonia (high and intermediate probabilities) while CXR reading was negative; in 14 of these cases, a CT scan or a RT-PCR-positive result confirmed the LUS interpretation. In 6 cases, LUS detected signs of alternative diagnoses to COVID-19 pneumonia while CXR was negative; in 4 of these cases, CT scan confirmed atypical findings. CONCLUSION: Our study demonstrated a strong disagreement between LUS interpretation and CXR reading in the early approach to patients suspected of COVID-19. Comparison with CT studies and RT-PCR results seems to confirm the superiority of LUS over a second retrospective reading of CXR.
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spelling pubmed-79077952021-02-26 Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19 Volpicelli, Giovanni Cardinale, Luciano Fraccalini, Thomas Calandri, Marco Piatti, Clara Geninatti, Carlotta Stranieri, Giuseppe Ultrasound J Original Article BACKGROUND: Lung ultrasound (LUS) and chest radiography (CXR) are the most used chest imaging tools in the early diagnosis of COVID-19 associated pneumonia. However, the relationship between LUS and CXR is not clearly defined. The aim of our study was to describe the comparison between LUS interpretation and CXR readings in the first approach to patients suspected of COVID-19. METHODS: In the time of the first COVID-19 pandemic surge, we prospectively evaluated adult patients presenting to an emergency department complaining of symptoms raising suspicion of COVID-19. Patients were studied by LUS and only those performing also CXR were analyzed. All the patients performed viral reverse transcriptase-polymerase chain reaction (RT-PCR). LUS studies were classified in 4 categories of probabilities, based on the presence of typical or alternative signs of COVID-19-associated interstitial pneumonia. Accordingly, the CXR readings were retrospectively adapted by 2 experts in 4 categories following the standard language that describes the computed tomography (CT) findings. Patients were divided in two groups, based on the agreement of the LUS and CXR categories. Results were also compared to RT-PCR and, when available, to CT studies. RESULTS: We analyzed 139 cases (55 women, mean age 59.1 ± 15.5 years old). The LUS vs CXR results disagreed in 60 (43.2%) cases. RT-PCR was positive in 88 (63.3%) cases. In 45 cases, a CT scan was also performed and only 4 disagreed with LUS interpretation versus 24 in the comparison between CT and CXR. In 18 cases, LUS detected signs of COVID-19 pneumonia (high and intermediate probabilities) while CXR reading was negative; in 14 of these cases, a CT scan or a RT-PCR-positive result confirmed the LUS interpretation. In 6 cases, LUS detected signs of alternative diagnoses to COVID-19 pneumonia while CXR was negative; in 4 of these cases, CT scan confirmed atypical findings. CONCLUSION: Our study demonstrated a strong disagreement between LUS interpretation and CXR reading in the early approach to patients suspected of COVID-19. Comparison with CT studies and RT-PCR results seems to confirm the superiority of LUS over a second retrospective reading of CXR. Springer International Publishing 2021-02-26 /pmc/articles/PMC7907795/ /pubmed/33635443 http://dx.doi.org/10.1186/s13089-021-00215-9 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Volpicelli, Giovanni
Cardinale, Luciano
Fraccalini, Thomas
Calandri, Marco
Piatti, Clara
Geninatti, Carlotta
Stranieri, Giuseppe
Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title_full Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title_fullStr Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title_full_unstemmed Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title_short Descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of COVID-19
title_sort descriptive analysis of a comparison between lung ultrasound and chest radiography in patients suspected of covid-19
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7907795/
https://www.ncbi.nlm.nih.gov/pubmed/33635443
http://dx.doi.org/10.1186/s13089-021-00215-9
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