Department of Diagnostic Radiology, Dae Rim St. Mary's Hospital, Department of Diagnostic Radiology1, and Internal Medicine2, College of Medicine, Korea University
ABSTRACT
PURPOSE : To evaluate the utility of ultrasonography as a guide of determination of therapeutic modality andto compare the therapeutic effects of modalities in patients with tuberculous pleural effusion. MATERlALS ANDMETHODS : This study included 47 patients who had multiple septations on ultrasonography. We classifiedultrasonographic pattern of pleural effusion into three groups according to pattern of septation : linear(n=6),moderate(n=19), honeycombing(n=22). We also classified therapeutic modalities into three groups : thoracentesisgroup(n=13), percutaneous catheter drainage group(n=11), intrapleural urokinase instillation group(n=23). Weassessed the early and late therapeutic effects of these groups prospectively with follow-up chest radiographs.RESULTS : There was statistically no significant difference in therapeutic effect among the groups that had linearand moderate septa on ultrasonography(p<0.01). In patients with honeycombing septa, the therapeutic effects ofcatheter group and urokinase group were superior to conservative thoracentesis group(p<0.01). In urokinase group,mean duration of drainage(6.6 days) was significantly shorter than catheter group's(12.4 days) (p<0.01).CONCLUSION : Pattern of septation on ultrasonography could be an useful factor for determination of thetherapeutic modality in patients with tuberculous pleural effusion. Percutaneous catheter drainage with urokinaseinstillation is a good therapeutic modality with shortened duration of drainage in treatment of pleural effusionwith honeycombing septae.
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