Accuracy of gray scale and color Doppler sonographic mapping in diagnosis of pneumonia in adult

Abstract Background Although the plain radiograph and computed tomography remain undoubtedly the primary imaging modalities in the investigation of pneumonia, ultrasound can play an important complementary role, in the diagnostic workup of the patients, and in their subsequent management. Objective To compare the accuracy of LUS with those of CXR and CT imaging in the diagnosis of pneumonia and compare color Doppler sonography and computed tomography (CT) for predicting necrotizing pneumonia. Methods Thirty-one patients with clinical suspicion of pneumonia were assessed by chest radiography, CT and sonography. Quantitative and qualitative sonographic examinations of the lesions were performed using grayscale and color Doppler imaging. The correlation between the color Doppler and CT findings was determined. Results LUS showed a high sensitivity (100%) and specificity (93.8%) and diagnostic accuracy was 96.8% in the diagnosis of pneumonia “which extend to pleural line”. It was almost a perfect agreement with CT findings ( K  = 0.93). The sensitivity of chest X-ray was low (60%). It was moderately in agreement with CT findings ( K  = 0.608). A significant change was seen in the flow pattern in comparison to the severity of necrosis by CT ( P value = 0.038). Conclusions Lung ultrasound imaging for the detection of pneumonia is highly accurate. Based on our results, LUS is a valid alternative for the diagnosis of pneumonia. By combined qualitative and quantitative impedance measurement, PA and bronchial artery (BA) can be differentiated from each other. Flow pattern of pulmonary arteries which was found in most of our cases was an indicative of benign lesions.