CO17 | Clinical utility of bedside contrast-enhanced ultrasound in the diagnosis of pneumonia in elderly patients: comparison with clinical, radiological and ultrasound diagnosis

F. Giangregorio, E. Mosconi, M.G. De Bellis, S. Provini, C. Esposito, M. Mendozza | Medicina e Gastroenterologia, Ospedale di Codogno (LO), Italy

Premises and Purpose of the study: to measure the clinical impact of contrast-enhanced ultrasound (CEUS) in the diagnosis of community-acquired pneumonia (CAP), compared to clinical, radiological and ultrasound diagnosis.
Materials and Methods: 84 patients (47/37 males/females, mean age:78,57±11,7 Y) with clinical suspicion of pneumonia and with ultrasound findings of peripheral lung lesions, were investigated with CEUS for a better characterization. Final diagnosis of 65 cap was obtained with complete disappearance of symptoms and pulmonary nodule(s); 19 neoplasms. Sensitivity, specificity, overall diagnostic accuracy (ODA) (and corresponding AUROC) of clinical-data (CD), chest X-ray(CXR), Lung-ultrasound(LUS), CEUS were calculated with SPSS 26.0 software.
Results: Final diagnosis: 65 CAP, and 19 chest cancers. CD: sens:35,4% spec:89,5% ODA10%: PPV:92%, NPV:28,8%; CXR: sens: 55,4%; spec: 73,7%; ODA: 32%; PPV:87,5%, NPV:32,66%. US: sens: 90,8%, spec: 73,7%, ODA: 84,9%, PPV:92,2%, NPV:70%; CEUS: sens: 96,9%; spec: 100% ODA: 97,5%; PPV: 100%, NPV:90,5%.
Conclusions: Clinical-data and chest X-RAYS are insufficient to obtain a correct diagnosis of CAP in elderly population; US demonstrated a good accuracy to establish CAP, but with a relatively low specificity; in these cases, CEUS is able to give a correct characterization, allowing you to save the need for a chest contrast-enhanced-CT (CECT).