American Journal of Roentgenology, Vol 159, 29-33, Copyright © 1992 by American Roentgen Ray Society

ARTICLES

Value of sonography in determining the nature of pleural effusion: analysis of 320 cases

PC Yang, KT Luh, DB Chang, HD Wu, CJ Yu and SH Kuo
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.

To assess the value of sonography in determining the nature of pleural effusions, we prospectively analyzed the sonographic findings in 320 patients with pleural effusion of various causes (224 with exudates and 96 with transudates). The nature of the effusions was established on the basis of chemical, bacteriologic, and cytologic examination of pleural fluid; pleural biopsy; and clinical follow-up. All patients had high-frequency, real-time sonography performed by one of three sonographers who had no clinical information concerning the patients. The sonographer evaluated the images for internal echogenicity of the effusion, thickness of the pleura, and associated parenchymal lesions of the lung. The images were also printed out and interpreted a second time by the other two sonographers to reach a consensus. Our results showed that the two types of effusions could be distinguished on the basis of sonographic findings. Transudates were anechoic, whereas an anechoic effusion could be either a transudate or an exudate. Pleural effusions with complex septated, complex nonseptated, or homogeneously echogenic patterns were always exudates (p less than .01). Sonographic findings of thickened pleura and associated parenchymal lesions in the lung also were indicative of an exudate (p less than .01). Homogenous echogenic effusions were due to hemorrhagic effusion or empyema. Sonographic evidence of a pleural nodule was a specific finding in patients with a malignant effusion. We conclude that sonography is useful in determining the nature of pleural effusion.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				B. A. Kurt, K. M. Winterhalter, R. H. Connors, B. W. Betz, and J. W. Winters Therapy of Parapneumonic Effusions in Children: Video-Assisted Thoracoscopic Surgery Versus Conventional Thoracostomy Drainage Pediatrics, September 1, 2006; 118(3): e547 - e553. [Abstract] [Full Text] [PDF]

				H.-J. Chen, W.-H. Hsu, C.-Y. Tu, Y.-H. Yu, K.-L. Chiu, L.-W. Hang, T.-C. Hsia, and C.-M. Shih Sonographic septation in lymphocyte-rich exudative pleural effusions: a useful diagnostic predictor for tuberculosis. J. Ultrasound Med., July 1, 2006; 25(7): 857 - 863. [Abstract] [Full Text] [PDF]

				D. Feller-Kopman Ultrasound-Guided Thoracentesis Chest, June 1, 2006; 129(6): 1709 - 1714. [Abstract] [Full Text] [PDF]

				M. H. Brutsche, G.-F. Tassi, S. Gyorik, M. Gokcimen, C. Renard, G. P. Marchetti, and J.-M. Tschopp Treatment of Sonographically Stratified Multiloculated Thoracic Empyema by Medical Thoracoscopy Chest, November 1, 2005; 128(5): 3303 - 3309. [Abstract] [Full Text] [PDF]

				A Medford and N Maskell Pleural effusion Postgrad. Med. J., November 1, 2005; 81(961): 702 - 710. [Abstract] [Full Text] [PDF]

				S. F. T. Thijsen, R. Luderer, J. M. H. van Gorp, S. J. G. Oudejans, and A. W. J. Bossink A possible role for Epstein-Barr virus in the pathogenesis of pleural effusion Eur. Respir. J., October 1, 2005; 26(4): 662 - 666. [Abstract] [Full Text] [PDF]

				C.-L. Chung, C.-H. Chen, J.-R. Sheu, Y.-C. Chen, and S.-C. Chang Proinflammatory Cytokines, Transforming Growth Factor-{beta}1, and Fibrinolytic Enzymes in Loculated and Free-Flowing Pleural Exudates Chest, August 1, 2005; 128(2): 690 - 697. [Abstract] [Full Text] [PDF]

				I M Balfour-Lynn, E Abrahamson, G Cohen, J Hartley, S King, D Parikh, D Spencer, A H Thomson, D Urquhart, and on behalf of the Paediatric Pleural Diseases Subco BTS guidelines for the management of pleural infection in children Thorax, February 1, 2005; 60(suppl_1): i1 - i21. [Full Text] [PDF]

				A. Roch, M. Bojan, P. Michelet, F. Romain, F. Bregeon, L. Papazian, and J.-P. Auffray Usefulness of Ultrasonography in Predicting Pleural Effusions > 500 mL in Patients Receiving Mechanical Ventilation Chest, January 1, 2005; 127(1): 224 - 232. [Abstract] [Full Text] [PDF]

				D R Warakaulle and Z C Traill Imaging of pleural disease Imaging, October 1, 2004; 16(1): 10 - 21. [Abstract] [Full Text] [PDF]

				C.-Y. Tu, W.-H. Hsu, T.-C. Hsia, H.-J. Chen, K.-D. Tsai, C.-W. Hung, and C.-M. Shih Pleural Effusions in Febrile Medical ICU Patients: Chest Ultrasound Study Chest, October 1, 2004; 126(4): 1274 - 1280. [Abstract] [Full Text] [PDF]

				C.-F. Chian, W.-L. Su, L.-H. Soh, H.-C. Yan, W.-C. Perng, and C.-P. Wu Echogenic Swirling Pattern as a Predictor of Malignant Pleural Effusions in Patients With Malignancies Chest, July 1, 2004; 126(1): 129 - 134. [Abstract] [Full Text] [PDF]

				S-F Ko, S-H Ng, T-Y Lee, P-L Sun, S-Y Lee, and C-C Hsiao Pedunculated malignant peripheral nerve-sheath tumour of the diaphragm presenting as recurrent lung infection: ultrasound diagnosis Br. J. Radiol., August 1, 2003; 76(908): 574 - 576. [Abstract] [Full Text] [PDF]

				N A Maskell and R J A Butland BTS guidelines for the investigation of a unilateral pleural effusion in adults Thorax, May 1, 2003; 58(90002): ii8 - 17. [Full Text]

				C W H Davies, F V Gleeson, and R J O Davies BTS guidelines for the management of pleural infection Thorax, May 1, 2003; 58(90002): ii18 - 28. [Full Text]

				C.-L. Chung, Y.-C. Chen, and S.-C. Chang Effect of Repeated Thoracenteses on Fluid Characteristics, Cytokines, and Fibrinolytic Activity in Malignant Pleural Effusion Chest, April 1, 2003; 123(4): 1188 - 1195. [Abstract] [Full Text] [PDF]

				S. Beckh, P. L. Bolcskei, and K.-D. Lessnau Real-Time Chest Ultrasonography: A Comprehensive Review for the Pulmonologist Chest, November 1, 2002; 122(5): 1759 - 1773. [Abstract] [Full Text] [PDF]

				S. Omori, Y. Takiguchi, K. Hiroshima, N. Tanabe, K. Tatsumi, H. Kimura, K. Nagao, and T. Kuriyama Peripheral Pulmonary Diseases: Evaluation with Endobronchial US— Initial Experience Radiology, August 1, 2002; 224(2): 603 - 608. [Abstract] [Full Text] [PDF]

				D.-M. Koh, S. Burke, N. Davies, and S. P. G. Padley Transthoracic US of the Chest: Clinical Uses and Applications RadioGraphics, January 1, 2002; 22(1): e1 - e1. [Abstract] [Full Text]

				K.-Y. Chen, P.-R. Hsueh, Y.-S. Liaw, P.-C. Yang, and K.-T. Luh A 10-Year Experience With Bacteriology of Acute Thoracic Empyema : Emphasis on Klebsiella pneumoniae in Patients With Diabetes Mellitus Chest, June 1, 2000; 117(6): 1685 - 1689. [Abstract] [Full Text] [PDF]

				O. H. Kim, W. S. Kim, M. J. Kim, J. Y. Jung, and J. H. Suh US in the Diagnosis of Pediatric Chest Diseases : (CME Available in print version and on RSNA Link) RadioGraphics, May 1, 2000; 20(3): 653 - 671. [Abstract] [Full Text] [PDF]