Ist eine Pleuritis sonographisch darstellbar?

Gehmacher, O.; Kopf, Alfred W.; Scheier, M.; Bitschnau, R.; Wertgen, T.; Mathis, Gebhard

doi:10.1055/s-2007-1000428

Cited by 41 publications

(8 citation statements)

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“…16 Similarly, pleural line abnormalities and small consolidations have varied and inconsistent definitions. Early work described a normal pleural line measuring up to 2 mm, 17,18 with abnormal pleura described as "thickened" with "hypoechoic broadening" 17 and measuring either more than 2 mm 18 or 3 mm [19][20][21] -all based on a linear array probe; however, as the pleural "thickness" observed in lung ultrasound is an artifact, its absolute width has no pathological correlate. 22 An international expert panel simply refers to an abnormal pleural line as "irregular" and "fragmented" with no size threshold.…”

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confidence: 99%

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Lung Ultrasound for Pleural Line Abnormalities, Confluent B‐Lines, and Consolidation

Fischer

Minami

W.Y.

et al. 2021

J of Ultrasound Medicine

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Objectives Discrete B‐lines have clear definitions, but confluent B‐lines, consolidations, and pleural line abnormalities are less well defined. We proposed definitions for these and determined their reproducibility using COVID‐19 patient images obtained with phased array probes. Methods Two raters collaborated to refine definitions, analyzing disagreements on 107 derivation scans from 10 patients. Refined definitions were used by those raters and an independent rater on 1260 validation scans from 105 patients. Reliability was evaluated using intraclass correlation coefficients (ICC) or Cohen's kappa. Results The agreement was excellent between collaborating raters for B‐line abnormalities, ICC = 0.97 (95% confidence interval [CI] 0.97–0.98) and pleural line to consolidation abnormalities, ICC = 0.90 (95% CI 0.87–0.92). The independent rater's agreement for B‐line abnormalities was excellent, ICC = 0.97 (95% CI 0.96–0.97) and for pleural line to consolidation was good, ICC = 0.88 (95% CI 0.84–0.91). Agreement just on pleural line abnormalities was weak (collaborators, κ = 0.54, 95% CI 0.48–0.60; independent, κ = 0.54, 95% CI 0.49–0.59). Conclusion With proposed definitions or via collaboration, overall agreement on confluent B‐lines and pleural line to consolidation abnormalities was robust. Pleural line abnormality agreement itself was persistently weak and caution should be used interpreting pleural line abnormalities with only a phased array probe.

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confidence: 99%

“…3 Rarely has a size criterion been assigned to consolidation, with both ≥15 mm 23 or 2-20 mm previously described. 17 When B-line interpretation has been assessed, the interobserver agreement on its presence has been moderate. For example, Haaksma et al demonstrated that the agreement on <3 or ≥3 B-lines is transducer and rater dependent.…”

mentioning

confidence: 99%

Lung Ultrasound for Pleural Line Abnormalities, Confluent B‐Lines, and Consolidation

Fischer

Minami

W.Y.

et al. 2021

J of Ultrasound Medicine

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“…Ultrasound demonstrates a fragmented pleural reflex with small subpleural consolidations and multiple B-lines (fig. 11) [23]. …”

Section: Sonography and Sonomorphology Of Important Thoracic Emergenciesmentioning

confidence: 99%

Emergency Ultrasound of the Chest

Kreuter

Mathis

2014

Respiration

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Thoracic ultrasound is a noninvasive and portable diagnostic tool which is highly indicated for an initial workup of thoracic emergencies. The suspicion of a pneumothorax, pneumonia, pulmonary embolism or a lung contusion after trauma can be quickly assessed using ultrasound. Main advantages are its good availability and the steep learning curve. Another advantage of thoracic sonography is that this rapid, symptom-based examination has a high sensitivity and specificity. However, a disadvantage is that only pleura-affecting lesions or lesions visible through a sound window, e.g. an effusion or a subpleural consolidation, can be reached.

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“…Ultrasonography is the most sensitive method for the verification of septa. A preceding sonographic examination may avoid [19]. Die pleurale entzündliche Hyperämie kann im kontrastverstärkten Ultraschall nachgewiesen werden, dies ist in der Routinediagnostik allerdings verzichtbar [20].…”

Section: Complex Pleural Effusionunclassified

“…In 90 % of patients with pleuritis a thickening and roughening of the pleura can be seen on the usually smooth pleural membrane during sonographic examination of the area of pain. In two thirds of cases small subpleural infiltration can be detected on the side of the lung, as can localized or basal pleural effusions [19]. Inflammatory pleural hyperemia is proven to exist with contrastenhanced ultrasound, but this finding is expendable in routine diagnostics [20].…”

Section: Pleurisymentioning

confidence: 99%