A Comparison Study In Children With Lower Respiratory Tract Infections: Chest X-Ray and Lung Ultrasound

INTRODUCTION: Lower respiratory tract infections are one of the leading causes of mortality and morbidity in children. Chest X-Rays, which are frequently used in the diagnosis, cause ionizing radiation exposure and loss of time. We aimed to compare the diagnostic accuracy of chest radiography (CR) and lung ultrasonography (US) in patients with lower respiratory tract infections (LRTI).
METHODS: The study was designed as methodological research. Of the 62 patients evaluated in our study, four refused to participate, and eight were excluded from the study due to their underlying chronic diseases. All 50 patients (between the ages of 0-18 years)were evaluated with a preliminary lower respiratory tract infection diagnosis. Lung US was performed by a 3rd-year pediatric resident who had six hours of online ultrasonography training. CR was taken after Lung US.
RESULTS: The mean age of the 50 cases included in this study was five years and three months; 35 of 50 patients (70%) had a clinical diagnosis of pneumonia, 15 (30%) of them had a clinical diagnosis of bronchiolitis. Statistically significant interobserver agreement was found between US and CR (Kappa value 0.772, 95% Confidence Interval (0.590-0.925) (p=0.000). The sensitivity of lung US was 95%, the specificity was 85.7% when the CR was accepted as the gold standard.

DISCUSSION AND CONCLUSION: Our study demonstrates that lung US could be used instead of CR to diagnose and follow-up pediatric cases with LRTI.