الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Aim of the Work
to study the usefulness of chest ultrasound as a complementary thoracic imaging technique to chest x-rays in evaluation of respiratory distress in pediatrics to establish the exact diagnosis of most pediatric thoracic abnormalities.
Summary
Evaluation of the infants who present with respiratory distress is a frequent problem in pediatric emergency department or clinic.
There is a great deal of clinical overlap in different chest diseases in pediatrics and it is essential and often life saving to make an early and accurate diagnosis. Ultrasonography of the chest can provide information that radiological imaging failed to give.
Our aim in this study was to evaluate the usefulness of ultrasonography as a complementary thoracic imaging technique to chest radiograph in diagnosing pediatric chest diseases. This study included 60 patient presented with respiratory distress. Patients had cardiac, neurologic, hematologic or metabolic disorders were excluded from the study. For all patients, full medical history, thorough clinical examination, chest X-rays and chest ultrasonographies were done. CT chest was done in selected cases to prove the diagnosis. In this study, patients were classified, based on final diagnosis, into 6 groups. The first group included 27 patients with pulmonary parenchematous diseases. US has reported sensitivity of 81.4%, specificity of 100%, positive predictive of 100% and negative predictive value of 84.3% in this group. The second group included 22 patients with pleural diseases. The sensitivity of chest ultrasound for diagnosis of pleural diseases was 100%, specificity was 100%, positive predictive value was 100%, and negative predictive value 100%. The third group included 4 patients with pleuropulmonary diseases. The fourth group included 4 patients with mediastinal diseases. The sensitivity of chest ultrasound in diagnosing mediastinal diseases was 25%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 57.1%. The fifth group included 2 patients with diaphragmatic diseases in the form of congenital diaphragmatic hernia. In this group, the sensitivity of chest ultrasound was 100%, specificity was 100%, positive predictive value was 100%, and negative predictive value 100%. The last group included 1 patient with bronchial disease in the form of bronchial asthma which diagnosed clinically without radiological findings.
The advantages of chest US include examination in multiple planes, the absence of ionizing radiation , of lower cost, easy performance at bed side, flexibility, short examination time as compared with computed tomography scan and high sensitivity in detecting pleural lesions and differentiating them from parenchymal disease . Also US is excellent for evaluation of the diaphragm as well as the anatomic structures above and below the diaphragm. US of the mediastinum have a screening role in the evaluation of mediastinal masses, somewhere between the role of chest radiography and those of the more expensive imaging techniques, especially in children in whom thymus can provide an excellent acoustic window. Sonographically guided aspiration biopsy and thoracocentesis can be performed accurately and easily.
In Conclusion, the chest ultrasonography has a complementary role to the chest X-ray in the diagnosis of the most of the pediatric chest diseases. Also it is useful in the therapeutic management of the some chest diseases (as pleural effusions).