Chest computed tomography versus transthoracic ultrasonography in study of gross pleural pathology in patients with pleural effusion

Objective Pleural effusion is a common medical problem occurring owing to various causes, and the diagnostic panel includes various diagnostic modalities. The rationale is to compare the accuracy of chest computed tomography (CT) versus transthoracic ultrasound (TTUS) in the detection of gross pathological pleural derangement through confirmatory thoracoscopic examination. Patients and methods A total of 50 patients with undiagnosed exudative pleural effusion were included, in whom the two radiological modalities were performed and compared with the results of thoracoscopy. Results A total of 18 (36%) female and 32 (64%) male patients were included, with a mean age of 50±14.95 years. TTUS showed superiority in the assessment of the pleura regarding thickening, nodulation, trabeculation, septation, encystation, and invasion of the chest wall in relation to the thoracoscopic findings, over the CT, which was statistically significant (P=0.0001). Moreover, it showed higher sensitivity and specificity than CT in all examined items. This is in addition to the known advantages of the TTUS being noninvasive, less expensive, and no exposure to radiation. Thus, it is recommended as a sole imaging procedure of choice in assessment of the pleura in adjunct to thoracoscope.