Correlation between clinical and chest ultrasound findings in infants with bronchiolitis: A preliminary study

Abstract

The chest ultrasound (CU) of bronchiolitis (B) in infants can reveal under thepleura focal or diffuse interstitial infiltrations (Ii)with/without minimal alveolar consolidations or microatelectasis (CA), pleural effusions, and pneumothorax. The purpose of the study has been to correlate CU findings to severity of clinical manifestations in infants with B. The study was conducted on infants hospitalized for B in our Pediatric Unit. Clinical severity of B was classified in mild, moderate and severe stages. CU features were distinguished in two categories: with/without CA. CU was executed by means of 10–12 MHz lineararray transducer in supine and prone position. Correlations were analyzed by using Fisher's exact test and Mann–Whitney test. Twenty-five infants were enrolled (11 males, median age: 4.0 months). Clinically 44% had mild B, 40% moderate and 16% severe. 78% of infants were positive to Respiratory Syncytial Virus test and 8% were normal at CU. Diffuse interstitial infiltrations were present in 82% (18% with CA) of patients with mild B, in 90% (70% with CA) with moderate B and in the totality of severe B (75%with CA). 8% hadminimal pleural effusion, none had pneumothorax. CAs were well correlated (p<0.001) to some clinical findings (moderate–severe stage, crackles, difficult to feed),moreover the timeof hospital dischargewas longer in B with CA (p<0.01). Alveolar consolidations or microatelectasis with diffuse interstitial infiltrations are most frequently associated to more severe clinical forms of B in infants.