Lung ultrasonography is a reliable radiation free imaging technique for the evaluation of lung diseases in children and could become a useful tool to reduce radiation exposure1,
especially in pediatric intensive care units,
where bedside chest X-rays are performed almost daily 2.
The aim of our study is to compare the diagnostic performance of lung ultrasonography and chest radiography for the detection of common pathologic abnormalities3.
Methods and materials
Thirty-three children admitted in the intensive care-unit were prospectively studied: they were included in the study when a bedside chest radiography was ordered by the primary physician not included in the study.
Lung ultrasound was performed immediately after chest radiography by a blinded operator.
Consolidation (including atelectasis),
pneumothorax and pleural effusion were evaluated.
Anterior-posterior CXR was performed using a portable X-ray equipment (Carestream DRX Revolution).
The evaluation of CXR was performed by an expert radiologist,
unaware of the lung ultrasound.
Visualization of the...
Pleural effusion was demonstrated in 6 CXR examinations,
while 20 LUS exams resulted positive (Fig. 1).
Pneumothorax4 was detected in 1 CXR exam as well as in LUS(Fig. 2).
Consolidation5,6 was diagnosed in 33 CXR while in 43 LUS (Fig. 3).
Interstitial syndrome7 was detected in 44 CXR while in 39 LUS (Fig. 4).
Agreement analysis showed perfect overall agreement between LUS and CXR for pneumothorax diagnosis (100% agreement,
Cohen Kappa coefficient 1),
substantial agreement for pulmonary consolidation (84%,
moderate agreement for interstitial...
the results of this study shows that lung ultrasonography is an accurate and reliable method of diagnosing common pathological abnormalities and does not expose young patients to radiation  in contrast to chest radiography and HRCT,
which carry a risk of DNA damage and are,
associated with an increased risk of cancer.
Bedside lung ultrasound examination is both feasible and convenient in critical care pediatric units and may eventually replace chest radiography and CT scanning at least if it does not shows...
Correspondance to: Martina Mughetti,
Cardio-Thoracic Radiology Unit,
S.Orsola Malpighi University Hospital,
Croasdale PL (2002) Radiation dose quantities and risk in neonates in a special care baby unit.
Br J Radiol 75(895):590-5
Zagli G et al (2010) The use of point-of-care bedside lung ultrasound significantly reduces the number of radiographs and computed tomography scans in critically ill patients.
Anesthesia and analgesia 111(3):687-692
Vaporidi K et al (2011) Lung ultrasound in critically ill patients: comparison with bedside chest radiography.
Intensive Care Medicine 37:1488-1493