Lung imaging during acute chest syndrome in sickle cell disease: computed tomography patterns and diagnostic accuracy of bedside chest radiograph
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INTRODUCTION: The lung computed tomography (CT) features of acute chest syndrome (ACS) in sickle cell disease patients is not well described, and the diagnostic performance of bedside chest radiograph (CR) has not been tested. Our objectives were to describe CT features of ACS and evaluate the reproducibility and diagnostic performance of bedside CR. METHODS: We screened 127 consecutive patients during 166 ACS episodes and 145 CT scans (in 118 consecutive patients) were included in the study. RESULTS: Among the 145 CT scans, 139 (96%) exhibited a new pulmonary opacity and 84 (58%) exhibited at least one complete lung segment consolidation. Consolidations were predominant as compared with ground-glass opacities and atelectasis. Lung parenchyma was increasingly consolidated from apex to base; the right and left inferior lobes were almost always involved in patients with a new complete lung segment consolidation on CT scan (98% and 95% of cases, respectively). Patients with a new complete lung segment consolidation on CT scan had a more severe presentation and course as compared with others. The sensitivity of bedside CR for the diagnosis of ACS using CT as a reference was good (>85%), whereas the specificity was weak (<60%). CONCLUSIONS: ACS more frequently presented on CT as a consolidation pattern, predominating in lung bases. The reproducibility and diagnostic capacity of bedside CR were far from perfect. These findings may help improve the bedside imaging diagnosis of ACS.
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The fundamental lesion of acute chest syndrome is a hyperinflammatory event leading to classic acute lung injury, defined by alveolar-capillary leak and neutrophilic inflammation, most commonly in two or more dependent lobes, which may be radiographically and clinically indistinguishable from multilobar pneumonia.
“The fundamental lesion of ACS is a hyperinflammatory event leading to classic acute lung injury (Figure 4), defined by alveolar-capillary leak and neutrophilic inflammation, most commonly in two or more dependent lobes, which may be radiographically and clinically indistinguishable from multilobar pneumonia (206).”
From Pathophysiology of Sickle Cell Disease (2019) · cites this paper as [206]
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- Authors
- Mekontso Dessap, A., Deux, J.-F., Habibi, A., Abidi, N., Godeau, B., Adnot, S., Brun-Buisson, C., Rahmouni, A., Galacteros, F., & Maitre, B.
- Affiliations
- Université Paris-Est Créteil (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Universitaire Henri-Mondor (FR)
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2013-08-07
- Volume
- 69
- Issue
- 2
- Pages
- 144-151
- ISSN
- 0040-6376 (ISSN-L)
- 1468-3296
- PMC
- PMC5104836
- OpenAlex
- W2111365428
- Cited by
- 50
- References
- 33
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 8 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 7 · 2014: 1
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Health Sciences › Medicine › Internal Medicine › Venous Thromboembolism Diagnosis and Management
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Ultrasound in Clinical Applications
- Keywords
- acute chest syndrome, sickle cell disease, lung CT, diagnostic accuracy, pulmonary opacities, atelectasis, ground-glass opacities, inferior lobe, disease severity
- MeSH terms
- Adult, Anemia, Sickle Cell, Female, Humans, Lung, Male, Prognosis, Prospective Studies, Sensitivity and Specificity, Tomography, X-Ray Computed, Reproducibility of Results, Point-of-Care Systems, Young Adult, Acute Chest Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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