Online citations, reference lists, and bibliographies.
← Back to Search

Computed Tomography And Ultrasound In Parapneumonic Effusions And Empyema.

S. Kearney, C. W. Davies, R. Davies, F. Gleeson
Published 2000 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
AIM Imaging of pleural empyema by ultrasound (US) or computed tomography (CT) is used to confirm the diagnosis and facilitate drainage. However, the information gained from US and CT may also have prognostic significance. The aim of the present study was to determine if CT and US appearances correlated with the severity of infection as determined by established microbiological and biochemical indicators, and to establish whether either technique could predict those patients who will fail drainage and require surgery. MATERIALS AND METHODS Fifty patients with parapneumonic effusions were assessed. All had thoracic CT and the results of thoracic US were available in 36 patients. Imaging features were compared to the stage of the effusion and clinical outcome. RESULTS At US, 7/36 (19%) pleural collections were anechoic, 5/36 (14%) were hyperechoic without septae and 24/36 (67%) were hyperechoic with septae. There was no relationship between US appearances and the presence of pus, the effusion stage or the need for surgical treatment. On CT pleural enhancement was seen in all patients. There was evidence of pleural thickening in 46/50 (92%) and thickening of extrapleural fat in 38/50 (76%). There was a trend for mean pleural thickness to increase with an increasing stage of pleural infection. However, a wide range of appearances were seen and overall the thickness of pleural/extrapleural tissues was not significantly related to the stage of effusion or to the requirement for surgery. CONCLUSIONS Although US and CT have established roles in the investigation of parapneumonic effusions, neither technique reliably identifies the stage of pleural infection or predicts those patients who subsequently require surgical intervention after failed management by chest tube drainage and intrapleural fibrinolytics. Kearney, S. E. (2000). Clinical Radiology 55, 542-547.
This paper references
Pleural fluid chemical analysis in parapneumonic effusions. A meta-analysis.
J. Heffner (1995)
The prognostic value of loculations in parapneumonic pleural effusions.
R. B. Himelman (1986)
Management of parapneumonic effusions.
R. Light (1991)
Value of sonography in determining the nature of pleural effusion: analysis of 320 cases.
P. C. Yang (1992)
Pleural exudates and transudates: diagnosis with contrast-enhanced CT.
S. Aquino (1994)
Predicting factors for outcome of tube thoracostomy in complicated parapneumonic effusion for empyema.
H. Huang (1999)
The sonographic appearances of pleural fluid.
D. Lomas (1993)
Management of complicated parapneumonic effusions.
S. Sahn (1993)
Streptokinase for empyema
M. Muers (1997)
CT follow-up of empyemas: pleural peels resolve after percutaneous catheter drainage.
C. Neff (1990)
Utility of pleural fluid analysis in predicting tube thoracostomy/decortication in parapneumonic effusions.
R. H. Poe (1991)
Parietal pleural changes in empyema: appearances at CT.
R. J. Waite (1990)
The contribution of leukocytes and bacteria to the low pH of empyema fluid.
S. Sahn (1983)
Pleural effusions: the diagnostic separation of transudates and exudates.
R. Light (1972)

This paper is referenced by
BTS guidelines for the management of pleural infection.
C. Davies (2003)
Empyema and Effusion: Outcome of Image-Guided Small-Bore Catheter Drainage
A. Keeling (2007)
Current treatment of pediatric empyema.
J. Hawkins (2004)
Videotoracoscopia temprana en el tratamiento de las neumonías complicadas con derrame pleural en niños
J. Méndez (2006)
guideline 2010 adults: British Thoracic Society pleural disease Investigation of a unilateral pleural effusion in
C. Hooper (2010)
Percutaneous management of parapneumonic effusions.
O. Ozkan (2005)
Infections of the Pleural Cavity
Philippe R Nafteux (2009)
Imaging of Chest Infections in Children
G. Choy (2010)
Pharmacotherapy in complicated parapneumonic pleural effusions and thoracic empyema.
S. Schiza (2005)
Infections of the lungs and pleura
D. Hansell (2010)
Les infections invasives a pneumocoque chez l’enfant : A propos de 46 cas colliges a l’hôpital d’enfant de rabat
Siham Darfouf (2008)
Management of pleural effusions
T. Tsitsias (2020)
Interventional radiology of pleural diseases
T. Matin (2011)
Using ultrasonography in the diagnosis and management of pleural disease
Sandra K. Gilley (2008)
Diagnosis of pleural infection: state-of-the-art
Claire L. Tobin (2012)
Pulmonary Infections in the Normal Host
L. Ketai (2012)
Behandlung des Pleuraempyems
M. Klopp (2007)
The accuracy of pleural ultrasonography in diagnosing complicated parapneumonic pleural effusions
Philip Z Svigals (2016)
The Diagnostic Role of Ultrasound in the Chest
N. Stephens (2007)
The Use of a Novel Quantitative Marker of Echogenicity of Pleural Fluid in Parapneumonic Pleural Effusions
Charalampos Varsamas (2020)
What imaging should we perform for the diagnosis and management of pulmonary infections?
S. Westra (2009)
S62 Appearances of empyema on CT: analysis of the MIST 2 Cohort
J. Franklin (2011)
Transthoracic US of the chest: clinical uses and applications.
D. Koh (2002)
Comparison of urokinase and video-assisted thoracoscopic surgery for treatment of childhood empyema.
S. Sonnappa (2006)
[Transthoracic ultrasonography in diagnosis and treatment of acute pleural empyema].
R. Stevic (2007)
The Utility of Ultrasonography in Diseases of the Pleura.
Lucía Ferreiro (2017)
Role of interventional pulmonology in the management of complicated parapneumonic pleural effusions and empyema
D. Breen (2014)
Derrame pleural parapneumônico e empiema* Parapneumonic effusion and empyema
E. Marchi (2006)
Inflammation et fibrose pleurale
I. Mahjoubi (2006)
Management Principles of Empyema
A. Gonzalez (2013)
Post-traumatic empyema: aetiology, surgery and outcome in 125 consecutive patients.
J. O'connor (2013)
Role of routine computed tomography in paediatric pleural empyema
A. Jaffe (2008)
See more
Semantic Scholar Logo Some data provided by SemanticScholar