Evaluation of Pleurodesis Success in Malignant Pleural Effusion Using Radiologic Modalities: The Role of Thoracic Ultrasound, CT, and Chest X-Ray
Keywords:
Malignant Pleural Effusion, Pleurodesis, CT, X-RayAbstract
Background: Malignant pleural effusion (MPE) is a frequent issue in advanced cancers. It leads to serious breathing problems and reduces the quality of life. Doctors often use chemical pleurodesis to prevent the fluid from returning. Assessing how well pleurodesis works is important for clinical decisions. Imaging methods like ultrasound, computed tomography (CT), and chest X-ray are key for checking results after the procedure. Objective: To evaluate the effectiveness of pleurodesis in patients with malignant pleural effusion using thoracic ultrasonography, computed tomography, and chest radiography, focusing on the absence of pleural sliding as a sign of successful treatment. Methodology: This study was performed at the Department of Medicine, Kabir Medical College, Peshawar. Fifty-four patients with malignant pleural effusion had intercostal chest tubes inserted, and then underwent chemical pleurodesis with bleomycin. Transthoracic ultrasound was done by researchers before the procedure, and again one month later to assess for the pleural sliding sign. Chest X-rays and CT scans also aided in determining the success of the pleurodesis. Results: Out of the 54 patients, 43 (79.6%) had successful pleurodesis. This was signified with no pleural sliding on ultrasound, a lack of recurrence of pleural effusion on CT and X-ray. In the mammary and supra-mammary regions, 81.5% had loss of sliding. Axillary and posterior regions, 77.8% and 75.9% loss of sliding, respectively. There was no significant difference in the results based on the type of sclerosing agent employed in the procedure. Conclusion: Transthoracic ultrasound is a trustworthy and effective non-invasive tool to evaluate the success of pleurodesis in malignant pleural effusion; the loss of the pleural sliding sign is associated with effective pleural adhesion. The CT and X-ray assessments support the ultrasound findings and use of sclerosing agent type did not significantly influence outcomes of pleurodesis.References
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