Diagnostic Value of Chest Ultrasound in Detecting Causes of Radiological Opacities in Comparison to CT Scan Among Children at Assiut University Children Hospital

Lung disease are the most common condition in pediatrics and also the primary cause of death among children less than 5 years old(Chen Shui-Wen et al.,2015).

Chest X ray consider as the first line to evalute the chest disease (Kim O et al. ,2000), in identified the pulmonary opacities (Ozkaya A et al., 2018),but there is limitation in the interpretation of the location and nature of an area of increase opacity on chest radiographs particularly in young infants with varied configuration of thymus and differentiation between pulmonary , pleural and mediastinal lesions is not always easy(Barillari A et al .,2011),so the thoracic computed tomography is recommended as diagnostic gold standard to follow up pediatric chest X ray opacities and masses(Lameh A et al. ,2019),but not consider as first line of radiological evaluation because each chest computed tomography gives to patient an effective dose of eight msv equivalent to four hundred chest X ray (Prithviraj D.,2014), also high cost ,and longe waiting times for imaging (Lameh A et al .,2019).

Chest sonography consider as first line investigation in evaluation of diaphragmatic ,pleural and chest wall lesions due to lack of superficial adipose tissue in pediatric patients (Goh Y, et al. ,2016),but undervalued for lungs lesion for many years ,because the ribs ,sternum and aerated lungs had been considered obstacles to ultrasound waves (Dietrich C, et al., 2015). However improvements in technology have lead to production of higher-resolution transducers and techniques such as tissue harmonic imaging, which lead to improved spatial resolution and deeper tissue penetration of ultrasound waves (Lameh A et al. ,2019),also the pathological processes as inflammations ,trauma or neoplastic within the chest wall ,pleural, and lungs result in profound changes in tissue composition and improved acoustic transmission and allow for adequate lungs sonographic evaluation(Dietrich C, et al., 2015).

Chest sonography serves as a powerful complementary diagnostic tool with advantage of easy availability ,rapid ,radiation free (Dietrich C, et al., 2015), repeatable and inexpensive methods, determining the high diagnostic accuracy in detecting pediatric chest lesions (Lameh A et al .,2019).

Causes of pediatric chest X ray opacity: