Diagnostic efficacy and suitability of trans-thoracic ultrasound for pleural effusion detection–The future non-invasive gold-standard. (study of 4597 cases)

Abstract

<b>Background:</b> Pleural effusions are suspected by history of pleuritis, evaluated by physical signs and multiple view radiography while aspirated pleural fluid is considered the gold-standard. Chest ultrasound has high sensitivity for pleural effusions, free from radiation hazards, and feasible for use in ICU, pregnancy and pediatrics. This study was conducted to determine the diagnostic efficacy of trans-thoracic ultrasound for pleural effusions and evaluate its suitability to be a non-invasive gold-standard. <b>Patients and methods:</b> This retrospective study of 4597 cases was conducted at Gulab Devi Teaching Hospital, Lahore-Pakistan from November 2017 to July 2019. Adult patients with chest x-ray suggesting pleural effusions were included while patients &lt; 14 years and pregnant patients were excluded. Chest ultrasonography and ultrasound guided thoracentesis done. At least 10ml aspirated fluid was considered diagnostic for pleural effusion. Patient medical records were retrieved, reviewed and findings were recorded in the pre-formed proforma. Results were summarized, tabulated and statistical analysis was done using SPSS-16. <b>Results:</b> 2547/4597 cases (56.62%) were confirmed pleural effusion by chest sonography with sensitivity, specificity, PPV, NPV and diagnostic accuracy 100 % each. <b>Conclusions:</b> Trans-thoracic ultrasonography revealed an excellent efficacy and can be considered as non-invasive gold standard for detection of pleural effusion.