J Korean Radiol Soc.  1988 Jun;24(3):404-411. 10.3348/jkrs.1988.24.3.404.

Comparison of diagnostic modalities in the differentiation of lung abscess and empyema

• Choe KO
• Lee JD
• Yoo HS
• Oh KK

• KMID: 2359266
• DOI: http://doi.org/10.3348/jkrs.1988.24.3.404

Abstract

The potential difficulties in distinguishing a pleural based parenchymal abscess from a loculated pleuraleffusion or empyema on the basis of plain radiography have been well documented. However chest ultrasonography canprovide valuable informations about disease proecesses abutting the chest wall, despite the physical limitationsimposed by aerated lung and bony thorax that restrict the potential usefulness of sonography in chest diagnosis.Some authors proposed that chest CT can diagnose them more accurately and provides more valuable informations thanultrasonography can. We evaluated chest radiographs, CT and ultrasonogaraphy of 36 patients with suspected pleuralbased lung abscess or empyema for the comparison of diagnostic modalities in the differentiaton of these twodisease entities. The results were as follows. 1. CT scan could accurately differentiate empyema from parenchymallesions by observing wall characteristics, split pleura, adjacent lung compression and internal septations. 2. In90% paitents with suspected lung abscess or empyema, they could be differentiated with ultrasonography alone, byindentifying internal septation, echogenic layering along pleural surface and internal echo patterns. 3.Ultrasonography assitsted plain radiography could also distinguish them as accurately as chest CT. 4. Chestultrasonography was more valuable than CT in the evaluation of pleural thickening, septation andcompartmentalization of pleural cavity.

MeSH Terms

Abscess
Empyema*
Humans
Lung Abscess*
Lung*
Pleura
Pleural Cavity
Radiography
Radiography, Thoracic
Thoracic Wall
Thorax
Tomography, X-Ray Computed
Ultrasonography