[Diagnostic and prognostic elements of echography in parapneumonic pleural effusion]

A retrospective study was made with the purpose of testing Ultrasound usefulness in differential diagnosis between empyematous and non empyematous evolution of parapneumonic effusions. A total of 64 patients with pneumonia and pleural effusion assisted between February 1st, 1982 and June 30th, 1989 had an Ultrasound transparietal study at the beginning and after 3 and/or 7 days of admission, with a real time equipment and a 3.5 Mhz linear transducer; they ranged between 12 and 90 years old, 27 were females and 37 males. Of these, 51 were cured by medical treatment, and 13 needed surgical drainage because of empyema evolution. The very high significant statistic signs of good prognosis in Ultrasound study were: free effusion (Table 2, p < 0.0002), maximal width less than 30 mm in sitting position (Table 1, p < 0.0001), unblurred peripleural images (Table 3, p < 0.002), and maximal homolateral diaphragmatic movement percentage more than 39% of the total (Table 4, p < 0.004); in the evolution, decrease of the maximal width effusion and slow improvement of diaphragmatic movement. Patients not included in the previous setting (31.2% of the total) were in the risk group (Fig. 1) and had loculated effusion, and/or maximal width of 30 mm or more, and/or blurred peripleural images, and/or homolateral maximal diaphragmatic movement percentage lower than 25% of the total. Less than half of this risk group was cured only with medical treatment; and they had an ultrasound evolution similar to the others cured in the same manner.(ABSTRACT TRUNCATED AT 250 WORDS)