Related Experiment Videos
Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those
José M Porcel1,2, Marina Pardina2,3, Carmen Alemán4
1Pleural Medicine Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, Lleida, Spain.
Respirology (Carlton, Vic.)
|April 4, 2017
Summary
A new computed tomography (CT) scoring system accurately identifies complicated parapneumonic effusions (PPEs) needing drainage. This CT grading scale aids clinicians in predicting the necessity for chest tube intervention in adults with PPE.
Area of Science:
- Radiology
- Thoracic Medicine
- Medical Imaging Analysis
Background:
- Parapneumonic effusions (PPEs) often require drainage, but identifying which ones necessitate intervention is challenging due to limited data.
- Computed tomography (CT) is a key imaging modality for evaluating pleural diseases.
Purpose of the Study:
- To develop and validate a CT-based scoring system for predicting the need for chest tube drainage in patients with PPE.
- To improve the accuracy of identifying complicated PPEs (CPPEs) requiring intervention.
Main Methods:
- Retrospective review of 149 patients with PPE who underwent thoracentesis and chest CT.
- Comparison of 11 CT characteristics between complicated (requiring drainage) and non-complicated PPE groups.
- Logistic regression analysis to identify independent predictors of CPPE and devise a scoring system, validated in an independent cohort.
Main Results:
- A CT scoring system incorporating pleural contrast enhancement, pleural microbubbles, increased extrapleural fat attenuation, and fluid volume ≥400 mL was developed.
- The scoring system achieved 84% sensitivity and 75% specificity for identifying CPPE in the derivation set (AUC: 0.829), with results validated in an independent sample.
- The CT grading scale also showed fair ability in predicting the need for surgery or mortality from pleural infection (AUC: 0.76).
Conclusions:
- A novel CT scoring system can accurately predict the need for chest tube drainage in adults with PPE.
- This CT-based grading scale offers a valuable tool for clinicians managing patients with parapneumonic effusions.