title: Can lung ultrasound replace chest radiography for the diagnosis of pneumonia in hospitalized children?
abstract: BACKGROUND
  Lung ultrasound is a non-radiating accurate alternative tool to chest X-ray (CXR) in the diagnosis of community-acquired pneumonia (CAP) in adults.
  
  
  OBJECTIVE
  The aim of our study was to define the accuracy of ultrasound in the diagnosis of CAP in children.
  
  
  METHODS
  107 consecutive children with suspected CAP underwent clinical examination, blood sample analysis, CXR and lung ultrasound on admission to the Pediatric Department of the San Paolo Hospital. The diagnosis of pneumonia was made by an independent committee of physicians on the basis of the overall clinical and CXR data.
  
  
  RESULTS
  The diagnosis of CAP was confirmed by the committee in 81 patients (76%). Ultrasound and CXR were performed in all patients. Ultrasound had a sensitivity of 94% and specificity of 96%, while CXR showed a sensitivity of 82% and a specificity of 94%. In patients with CAP, ultrasound revealed subpleural consolidations with air bronchogram in 70 cases and focal B-lines in 6. A parapneumonic pleural effusion was detected in 17 patients by ultrasound, while only 11 of them could be detected by CXR.
  
  
  CONCLUSIONS
  In our series, lung ultrasound was highly accurate for the diagnosis of CAP in hospitalized children. These results provide the rationale for a multicenter study in children.
authors.affiliation: Respiratory Unit, Dipartimento Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Reali
authors.forename: Giuseppe Francesco
authors.initials: GF
authors.lastname: Sferrazza Papa
authors.forename: Paolo
authors.initials: P
authors.lastname: Carlucci
authors.forename: Paola
authors.initials: P
authors.lastname: Fracasso
authors.forename: Fabiano
authors.initials: F
authors.lastname: Di Marco
authors.forename: Marzia
authors.initials: M
authors.lastname: Mandelli
authors.forename: Simone
authors.initials: S
authors.lastname: Soldi
authors.forename: Enrica
authors.initials: E
authors.lastname: Riva
authors.forename: Stefano
authors.initials: S
authors.lastname: Centanni
mesh_terms: D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D010996:Pleural Effusion / Q000000981:diagnostic imaging / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D013902:Radiography, Thoracic; D014463:Ultrasonography