Prevalence and clinical significance of pleural microbubbles in computed tomography of thoracic empyema

Smolikov, Alexander; Smolyakov, Rozalia; Riesenberg, Klaris; Schlaeffer, F.; Borer, Abraham; Cherniavsky, Eugenia; Gavriel, Aharon; Gilad, Jacob

doi:10.1016/j.crad.2006.02.004

Cited by 20 publications

(12 citation statements)

References 15 publications

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“…Certain CT findings have long been described as highly sensitive but non‐specific of empyemas. The sum of seven series, totalling 317 empyemas (mostly defined as fluids with purulent appearance or positive cultures) yielded a prevalence for different CT signs as follows: pleural contrast enhancement 93% (126/136), thickening of parietal pleura 90% (277/308), increased density of the extrapleural subcostal fat 77% (171/223), split pleura sign 75% (102/136), gas bubbles suspended within the pleural fluid 51% (84/164) and pleural loculations 51% (143/281) . It should be noted that the different criteria employed to define either empyema/CPPE (e.g.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics

et al. 2017

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“…In addition to the above findings, prominence of the extrapleural fat has been noted in up to 76% of patients with proven empyema [56]. Other features possibly present on CT are air-fluid levels and pleural microbubbles [57].…”

Section: Empyema and Parapneumonic Effusionmentioning

confidence: 91%

Pneumonia in the immunocompetent patient

Reynolds

McDonald²,

Alton³

et al. 2010

BJR

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Pneumonia is an acute inflammation of the lower respiratory tract. Lower respiratory tract infection is a major cause of mortality worldwide. Pneumonia is most common at the extremes of life. Predisposing factors in children include an under-developed immune system together with other factors, such as malnutrition and over-crowding. In adults, tobacco smoking is the single most important preventable risk factor. The commonest infecting organisms in children are respiratory viruses and Streptoccocus pneumoniae. In adults, pneumonia can be broadly classified, on the basis of chest radiographic appearance, into lobar pneumonia, bronchopneumonia and pneumonia producing an interstitial pattern. Lobar pneumonia is most commonly associated with community acquired pneumonia, bronchopneumonia with hospital acquired infection and an interstitial pattern with the so called atypical pneumonias, which can be caused by viruses or organisms such as Mycoplasma pneumoniae. Most cases of pneumonia can be managed with chest radiographs as the only form of imaging, but CT can detect pneumonia not visible on the chest radiograph and may be of value, particularly in the hospital setting. Complications of pneumonia include pleural effusion, empyema and lung abscess. The chest radiograph may initially indicate an effusion but ultrasound is more sensitive, allows characterisation in some cases and can guide catheter placement for drainage. CT can also be used to characterise and estimate the extent of pleural disease. Most lung abscesses respond to medical therapy, with surgery and image guided catheter drainage serving as options for those cases who do not respond.

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“…The clinical significance of air bubbles in the thoracic cavity has not been determined, even in human medicine. Two studies have suggested that patients with signs of intrathoracic air bubbles are more likely to have empyemic fluid requiring repeated drainage and surgical treatment, meaning that the disease process is more advanced . These findings have not been reported in the veterinary literature, and further studies are needed to determine the clinical relevance of intrathoracic air bubbles.…”

Section: Discussionmentioning

confidence: 99%

Multimodality imaging characteristics of tension pyopneumothorax secondary to pulmonary carcinoma in a cat

Kim

Yoon

Kim

et al. 2017

Vet Radiology Ultrasound

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A 3-year-old Himalayan cat was presented with respiratory distress. Radiography showed multiple gas opacity foci, with the locations dependent on patient positioning, and severe pleural effusion with a contralateral mediastinal shift. A large volume of fluid and air was aspirated, and the fluid components were consistent with a nonseptic exudate. A pulmonary mass, pleural nodules, and an air-fluid interface with air bubbles trapped in fibrous septations were identified using thoracic ultrasonography and CT. The cat died 2 days after imaging studies. Necropsy revealed tension pyopneumothorax caused by pulmonary carcinoma and multiple pleural metastases.

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Prevalence and clinical significance of pleural microbubbles in computed tomography of thoracic empyema

Cited by 20 publications

References 15 publications

Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics

Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics

Pneumonia in the immunocompetent patient

Multimodality imaging characteristics of tension pyopneumothorax secondary to pulmonary carcinoma in a cat

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