Pulmonary thromboembolism in children – is chest ultrasound useful?

Aim of study: To determine value of chest ultrasound in diagnosis of PTE in children.

Material and methods: We present medical history and chest ultrasound CU images of six children with risk of PTE. The study consists of 2 steps.

I. Chest sonographic images of three children (group A) were evaluated: 13 years old boy suffering from primary antyphospholipid syndrome, 14 years old boy with Wegener Granuloma disease and 15 years old girl who suffered from urosepsis. Results were compared to CT results.

II. We evaluated CU in three newborns with congenital heart disease (group B). Those children could not have other imaging test performed because of critical physical condition. Two boys were treated for HLHS and one boy for CoA and PDA.

In all six cases ultrasound examination was performed as emergency ultrasound using GE Loqic 500 equipment with linear probe 8,2–11,0MHz.

Results: In all cases the pulmonary thromboembolism was suggested based on ultrasound examination. In group A CT confirmed sonographic results. In both groups the chest sonograms showed bilateral peripheral subpleural hypoechoic lesions: in group A averaged –1.0×2.2cm (0.5–4.5) large triangular or oval in shape, accompanied by a small effusion. In group B average 0,5×1,8cm large.

Conclusions: Sonographic features in chest ultrasound examination should be considered in diagnosis pulmonary thromboembolism in children.

In our opinion bed side chest ultrasound examination is especially useful in children with high risk of PTE and critical physical condition.