Comparison of lung ultrasound and chest radiography for detecting pneumonia in children: a systematic review and meta-analysis

Abstract

Background Lung ultrasound (LUS) is recommended as a reliable diagnostic alternative to chest X-ray (CXR) for detecting pneumonia in children. Methods PubMed, Embase, and Cochrane Library databases were used to identify eligible studies from their inception until April 2023. The investigated diagnostic parameters included sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curves (AUC). Results Twenty-six studies involving 3,401 children were selected for meta-analysis. The sensitivity, specificity, PLR, NLR, DOR, and AUC of LUS for detecting pneumonia in children were 0.95, 0.92, 12.31, 0.05, 108.53, and 0.98, respectively, while the sensitivity, specificity, PLR, NLR, DOR, and AUC of CXR were 0.92, 0.93, 24.63, 0.08, 488.54, and 0.99, respectively. The sensitivity of LUS was higher than that of CXR for detecting pneumonia in children (ratio: 1.03; 95% CI: 1.01–1.06; P = 0.018), whereas the DOR of LUS was significantly lower than that of CXR (ratio: 0.22; 95% CI: 0.06–0.85; P = 0.028). Conclusions This study found that the diagnostic performance of LUS was comparable to that of CXR for detecting pneumonia, and the sensitivity of LUS was superior to that of CXR.

The Clinical Value of Non-invasive Lung Ultrasound in Assessing Pediatric Mycoplasma Pneumoniae Pneumonia

“…The LUS score was calculated as the sum of all regional scores ranging from 0-36 points. Classi cation of sever-ity of lung lesions [4]: none (0 points), mild (1-7 points), moder-ate (8-18 points), severe (≥ 19 points).…”

“…Some children may develop respiratory distress, and the condition can be life-threatening in severe cases [3] . Chest X-ray is a commonly used method to assess MPP but it has relatively low sensitivity and accuracy in diagnosing lung lesions [4] . Chest CT has become the "gold standard" for diagnosing lung diseases due to its advantages in comprehensively observing lung lesions [5] .…”