Radiological and Ultrasound Findings in Neonatal Respiratory Pathology: Perspectives in Diagnosis.

Background: The evaluation and management of neonatal respiratory pathologies require precise and careful diagnostic approaches, particularly in preterm infants who are at higher risk of respiratory complications. This research compares lung ultrasound (LUS) and chest X-ray for diagnosing and monitoring respiratory conditions in preterm and term neonates.

Methods: We conducted a prospective analysis of the imaging practices for neonatal respiratory pathologies in a cohort of 82 preterm and term infants with a gestational age ranging from 31-41 weeks presenting with respiratory distress syndrome (RDS) diagnostically categorized based on clinical and paraclinical investigations, who were admitted to the neonatal intensive care unit (NICU) immediately after birth.

Results: The most common diagnosis was moderate RDS, which affected 17 neonates, followed by moderate transient tachypnea of the newborn (TTN) in 16 patients, severe RDS in 14 patients and meconium aspiration syndrome (MAS) in 12 patients. Additionally, seven patients presented with mild RDS and six were diagnosed with congenital pneumonia. There were four cases of severe TTN, four cases of mild TTN and only two cases of pneumothorax. This study identified the ultrasound and radiological findings and aimed to highlight the current trend in the evaluation and management of respiratory conditions in preterm and term neonates. The results demonstrate an increasing trend in the use of ultrasound due to its advantages, especially in preterm patients who are at higher risk of respiratory impairment.

Conclusion: The benefits of ultrasound, including absence of radiation and dynamic imaging capabilities, make it a valuable tool for ongoing assessment and management. While X-rays remain an important imaging tool in certain clinical scenarios, their use should be judicious to minimize radiation exposure. These findings support the continued integration of ultrasound in neonatal practice and suggest further research into optimizing imaging protocols to improve long-term outcomes for neonates.