Differentiation of lung abscess and empyema by ultrasonography.
To assess the value of chest ultrasonography in the differentiation between a lung abscess and empyema, 50 patients, including 24 cases of lung abscess and 26 cases of empyema, were studied. The ultrasonographic characteristics of a lung abscess included an irregular wall width, a blurred outer margin, an oval or round shape, an acute chest wall angle and a negative pleural separation. The ultrasonographic characteristics of empyema were an uniform wall width, a sharp outer margin, a lenticular shape, an obtuse chest wall angle and a positive pleural separation. A new ultrasonographic scoring system was proposed; a positive finding for each of the features: sharp outer margin, lenticular shape, obtuse chest wall angle and positive pleural separation was assigned a score of 1, while a negative finding was assigned a score of zero. The total scores for the four features were then assessed. Ninety-six percent of the empyema cases scored 2 or more, while 96% of the lung abscess cases scored 1 or zero. The efficacy of differential diagnosis was 96%. We conclude that chest ultrasonography is a useful tool in the differentiation between lung abscess and empyema and that ultrasonography alone is sufficient to make a correct diagnosis in most cases.
Department of Clinical Pathology, National Taiwan University Hospital, Taipei, R.O.C.
H D
HD
Wu
P C
PC
Yang
L N
LN
Lee
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D016724:Empyema, Pleural / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008169:Lung Abscess / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography