Diagnostic and Interventional Radiology
Chest Imaging - Original Article

Efficacy of CT in diagnosis of transudates and exudates in patients with pleural effusion

1.

Departments of Urology, Dokuz Eylül University School of Medicine, İzmir, Turkey

2.

From the Department of Pulmonology Suruç State Hospital, Şanlıurfa, Turkey

3.

From the Departments of Radiology Harran University School of Medicine, Şanlıurfa, Turkey.

4.

Thoracic Surgery Harran University School of Medicine, Şanlıurfa, Turkey.

5.

Pulmonology Harran University School of Medicine, Şanlıurfa, Turkey.

Diagn Interv Radiol 2014; 20: 116-120
DOI: 10.5152/dir.2013.13066
Read: 1392 Downloads: 525 Published: 03 September 2019

Abstract

PURPOSE: 
We aimed to evaluate the efficacy of multidetector computed tomography (CT) imaging in diagnosis of pleural exudates and transudates using attenuation values. 

MATERIALS AND METHODS: 
This retrospective study included 106 patients who were diagnosed with pleural effusion between January 2010 and June 2012. After the patients underwent chest CT, thoracentesis was performed in the first week. The attenuation values of the pleural effusions were measured in all patients. 

RESULTS: 
According to Light’s criteria, 30 of 106 patients with pleural effusions had transudates, and the remaining patients had exudates. The Hounsfield unit (HU) value of the exudates (median, 12.5; range, 4–33) was significantly higher than that of the transudates (median, 5; range, 2–15) (P = 0.001). Additionally, when evaluated by disease subgroups, congestive heart failure and empyema were predictable in terms of median HU values of the pleural effusions with high and moderate sensitivity and specificity values (84.6% and 81.2%, respectively; 76.9% and 66.7%, respectively). Compared with other patients, the empyema patients had significantly more loculation and pleural thickening. 

CONCLUSION
CT attenuation values may be useful in differentiating exudates from transudates. Although there is an overlap in most effusions, exudate can be considered when the CT attenuation values are >15 HU. Because of overlapping HU values, close correlation with clinical findings is essential. Additional signs, such as fluid loculation and pleural thickness, should be considered and may provide further information for the differentiation.

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EISSN 1305-3612