Related Experiment Video
Updated: Jul 10, 2026
International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Thoracic Computed Tomography Scan Versus Thoracic Ultrasonography for Management Decisions in Empyema Thoracis: A
Davinder Kaur1,2, Ketan Kumar3, Pravakar Mishra4,5
1Advanced Centre for Evidence Based Child Health, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Context:
Although thoracic ultrasonography (USG) provides valuable information for managing empyema, many clinicians resort to thoracic computed tomography (CT) scans.
Objective:
This systematic review was conducted to synthesize evidence on the efficacy, safety and cost of thoracic CT scan versus USG for managing childhood empyema.
Evidence Acquisition:
We searched for diagnostic test accuracy studies and observational studies in PubMed, EMBASE, the Cochrane Library, Scopus, Web of Science, clinical trial registries and grey literature sources (ProQuest and OpenGrey), without any language restrictions. Two reviewers independently screened studies for inclusion. Studies in children (< 18 years) with confirmed empyema were included. The outcomes evaluated were findings impacting management missed by the other modality, adverse events, concordance, additional findings identified with either modality, and cost. Risk of bias was estimated using study design-specific tools. Certainty of evidence was evaluated using the GRADE approach.
Results:
Only one retrospective study with 13 participants met the inclusion criteria. CT identified one additional case with loculations compared to USG, and one additional lung abscess, although it was not confirmed at surgery. Fibrin strands seen on USG in all 13 cases were not detected by CT. Both modalities detected pulmonary consolidation in 11 patients; although the sites of consolidation differed in some children. There was no comparative data on cost and adverse events. The GRADE evidence certainty was judged as very low.
Conclusion:
The limited, very low certainty evidence suggested no advantage of CT scan over USG in the management of childhood empyema. Appropriately designed prospective studies can resolve this question.
Related Concept Videos
01:27Pneumothorax-II
Clinical Manifestations:
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:30Radiological Investigation I: X-ray and CT
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...