Evaluation of the lung in children with suspected pneumonia: usefulness of ultrasonography

The authors sought to evaluate the sensitivity of chest ultrasound (US) versus chest radiography in detecting lung consolidation and pleural effusion in children with a clinical suspicion of pneumonia. Thirty-two chest radiographs and 32 chest US examinations were performed in 28 consecutive patients (aged 4 months to 17 years) with a clinical suspicion of pneumonia. Chest US examinations were carried out with a convex-array broadband probe (2-5 MHz) and a high-frequency linear-array broadband probe (5-12 MHz). The results obtained were compared with those of chest radiography. Chest radiography identified subpleural consolidation in 22 patients, perihilar consolidation in 7, and pleural effusion in eight. In the same 22 patients, chest US showed 22 cases of subpleural consolidation but no cases of perihilar consolidation; pleural effusion was detected in 15 patients. Chest US is capable of identifying subpleural consolidation with the same sensitivity as chest radiography and is highly accurate in demonstrating pleural effusion. For this reason, chest US may be a valuable aid and possible alternative to standard chest radiography in the evaluation and follow-up of children with suspected pneumonia.