RT Journal Article
SR Electronic
T1 A simple score based on ultrasound criteria to distinguish between exudative vs. transudative pleural effusions
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P666
VO 44
IS Suppl 58
A1 Syed Muhammad Rashid Azam
A1 William T. Owen
A1 Meera Kamalanathan
A1 Tudor P. Toma
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P666.abstract
AB BackgroundUltrasound is an innovative, noninvasive method to examine pleural effusions. Sonographic appearances are considered useful in determining the nature of pleural effusion, but there is no validated tool (similar to Light's criteria), to differentiate a transudate from an exudate using ultrasound only.AimsTo explore the discriminative power of a score based on ultrasound criteria to differentiate a transudative pleural effusion.MethodsA total score was computed by adding one point if any of the following findings were observed: bilateral effusions, absence of loculated fluid, anechoic fluid, non-thickened pleura, congested liver, and non-collapsing inferior vena cava.We prospectively scored and then audited the sonographic diagnosis in 23 patients with pleural effusions. The nature of the effusion was established following a pleural aspirate on the basis of Light's biochemical criteria.ResultsBy Light's criteria 10 patients had transudates and 13 had exudates. There was a correlation of 85% between the sonographic diagnosis and the biochemical diagnosis of the effusions. The average sonographic score for an exudate was 2.07 (± 1.44), while the average score for a transudate was 4.4 (± 0.70) (p<0.05). For a score of ≥4 the sensitivity and specificity for a transudate was 0.80 and 0.81.ConclusionA simple sonographic score can distinguish a transudative pleural effusion and may reduce the number of diagnostic aspirations for effusions likely to be transudates. Larger prospective studies are required to validate these findings.