Ultrasound elastography: a novel tool for the differential diagnosis of pleural effusion
Bin Jiang, Xue-Lian Li, Yan Yin, Qin Zhang, Tong Zang, Wang-Shu Song, Xue-Mei Wang, Jian Kang, Felix J F Herth, Gang Hou, Bin Jiang, Xue-Lian Li, Yan Yin, Qin Zhang, Tong Zang, Wang-Shu Song, Xue-Mei Wang, Jian Kang, Felix J F Herth, Gang Hou
Abstract
Introduction: Traditional thoracic ultrasound (TUS) is often the initial tool used to help diagnose malignant pleural effusion (MPE). Ultrasound elastography, a relatively new technique, has been used to differentiate malignant disease from benign disease by evaluating tissue "stiffness". However, no studies evaluating the efficacy of ultrasound elastography for diagnosing MPE are available. We assessed the value of ultrasound elsatography for diagnosing MPE prospectively.
Methods: All 244 enrolled patients were divided into a development set and a validation set in chronological order. The cut-off elasticity index was established using a receiver operating characteristic curve constructed from the continuous data of the patients in the development set. The diagnostic performance of ultrasound elastography was compared with that of TUS in the validation set.
Results: In the development set, the mean elasticity index (47.25 kPa) was the optimal cut-off. In the validation set, pleural ultrasound elastography had a sensitivity of 83.64%, a specificity of 90.67%, a positive predictive value of 86.79%, a negative predictive value of 88.31%, a positive likelihood ratio of 8.96 and a negative likelihood ratio of 0.18 for diagnosing MPE. The sensitivity of ultrasound elastography was significantly higher (p=0.006) than that of TUS (60%).
Conclusion: Pleural ultrasound elastography is a better technique than TUS for differentiating MPE from benign pleural disease.
Conflict of interest statement
Conflict of interest: B. Jiang has nothing to disclose. Conflict of interest: X. Li has nothing to disclose. Conflict of interest: Y. Yin has nothing to disclose. Conflict of interest: Q. Zhang has nothing to disclose. Conflict of interest: T. Zang has nothing to disclose. Conflict of interest: W. Song has nothing to disclose. Conflict of interest: X. Wang has nothing to disclose. Conflict of interest: J. Kang has nothing to disclose. Conflict of interest: F.J.F. Herth has nothing to disclose. Conflict of interest: G. Hou has nothing to disclose.
Copyright ©ERS 2019.
Source: PubMed