title: Incremental value of pocket-sized imaging device for bedside diagnosis of unilateral pleural effusions and ultrasound-guided thoracentesis.
abstract: OBJECTIVE
  The present study aimed to assess the additional value of a pocket-sized imaging device (PSID) as an adjunct to plain chest X-rays in the diagnosis of pleural effusion (PE), mainly for those requiring pleural thoracentesis.
  
  
  METHODS
  We performed a thoracic ultrasound examination using a PSID in 73 patients with an abnormal chest X-ray diagnostic for unilateral PE. Abundant PE was defined as an interpleural distance between the diaphragm and visceral pleura (VP) of ≥ 30 mm at the apex of the 50 mm bisector line of the costodiaphragmatic recess at end expiration.
  
  
  RESULTS
  According to PSID ultrasound evaluation, abundant PE was present in 46 patients (63%), while 27 (37%) patients showed the presence of mild PE or absence of PE. Thoracentesis was performed successfully and without procedure-induced complications in all 46 patients with abundant PE. Using the above-mentioned method, we obtained a high diagnostic accuracy (area under the curve = 0.99) and excellent sensitivity and specificity of 91.7 and 99.9%, respectively, to predict a PE >1000 ml, when VP was >6.3 cm.
  
  
  CONCLUSIONS
  PSID is a useful tool that may integrate and complete the physical examination, also providing additional information to chest X-ray in the clinical management of patients with suspected PE. PSID evaluation can also increase the effectiveness and safety of thoracentesis.
authors: Department of Cardiovascular Diseases, University of Siena, Siena, Italy. matteo.lisi@hotmail.it
authors: Matteo
authors: M
authors: Lisi
authors: Matteo
authors: M
authors: Cameli
authors: Sergio
authors: S
authors: Mondillo
authors: Luca
authors: L
authors: Luzzi
authors: Valerio
authors: V
authors: Zacà
authors: Paolo
authors: P
authors: Cameli
authors: Giuseppe
authors: G
authors: Gotti
authors: Maurizio
authors: M
authors: Galderisi
mesh_terms: D000368:Aged; D019540:Area Under Curve; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D010996:Pleural Effusion / Q000000981:diagnostic imaging* / Q000601:surgery*; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation*