الفهرس | Only 14 pages are availabe for public view |
Abstract BACKGROUND: Ultrasound provides immediate information with real- time imaging and can give information not available from a standard radiograph or CT scan.The present study demonstrates that ultrasound is an accurate imaging modality for the evaluation of pleurodesis, in that the absence of pleural gliding on ultrasound correlates well with the presence of a successful pleurodesis. Gliding sign refers to to-and-fro movement of the visceral and parietal pleural surfaces during the respiratory cycle. The gliding sign would be absent if pleurodesis was present with fusion of the visceral and parietal pleural. METHODS: he present study was conducted upon twenty patients with pleural disease enrolled for pleurodesis (12 male and 8 female) with the mean age 58 years old, at the respiratory department of Ain Shams University Hospitals during the period between August 2015 and July 2016. Chest ultrasound was performed just before pleurodesis and then repeated after 2 weeks of the procedure. • • The outcome of pleurodesis was followed after 3 months for clinical and radiological evidence of recurrence of pleural effusion. In case of pneumothorax the evidence of success was based on ultrasonographic evidence of persistently absent pleural sliding The identified outcome was plotted against early ultrasonographic findings to determine the utility of chest ultrasonography in detection of results of the procedure. RESULTS: Ultrasound done 15 days after trial of pleurodesis showed absence of gliding sign in the scapular line in (70%) of the patients compared to no abnormalities in the gliding prior to the procedure and in mid axillary line in (60%) of the patients and in midclavicular area in (35%) of the patients compared to no abnormalities in the gliding prior to pleurodesis. Chest ultrasound found that pleurodesis was fully successful as judged by score of 19-21 in (35%) of cases and also was able to detect failure of the procedure as judged by a score 3-8 in (20%) of cases . CONCLUSIONS: A scoring system was verified to predict the early outcome of pleurodesis whether succeeded or failed, by a total score and a gliding sign score which was found to be of high significant correlation with the other imaging modalities such as the chest X-ray and CT chest. |