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A Simple Method for Differentiating Complicated Parapneumonic Effusion/Empyema from Parapneumonic Effusion Using the Split Pleura Sign and the Amount of Pleural Effusion on Thoracic CT

Author

Listed:
  • Naoki Tsujimoto
  • Takeshi Saraya
  • Richard W Light
  • Yayoi Tsukahara
  • Takashi Koide
  • Daisuke Kurai
  • Haruyuki Ishii
  • Hirokazu Kimura
  • Hajime Goto
  • Hajime Takizawa

Abstract

Background: Pleural separation, the “split pleura” sign, has been reported in patients with empyema. However, the diagnostic yield of the split pleura sign for complicated parapneumonic effusion (CPPE)/empyema and its utility for differentiating CPPE/empyema from parapneumonic effusion (PPE) remains unclear. This differentiation is important because CPPE/empyema patients need thoracic drainage. In this regard, the aim of this study was to develop a simple method to distinguish CPPE/empyema from PPE using computed tomography (CT) focusing on the split pleura sign, fluid attenuation values (HU: Hounsfield units), and amount of fluid collection measured on thoracic CT prior to diagnostic thoracentesis. Methods: A total of 83 consecutive patients who underwent chest CT and were diagnosed with CPPE (n=18)/empyema (n=18) or PPE (n=47) based on the diagnostic thoracentesis were retrospectively analyzed. Results: On univariate analysis, the split pleura sign (odds ratio (OR), 12.1; p

Suggested Citation

  • Naoki Tsujimoto & Takeshi Saraya & Richard W Light & Yayoi Tsukahara & Takashi Koide & Daisuke Kurai & Haruyuki Ishii & Hirokazu Kimura & Hajime Goto & Hajime Takizawa, 2015. "A Simple Method for Differentiating Complicated Parapneumonic Effusion/Empyema from Parapneumonic Effusion Using the Split Pleura Sign and the Amount of Pleural Effusion on Thoracic CT," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0130141
    DOI: 10.1371/journal.pone.0130141
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