• Aziz Gümüş, Neslihan Özçelik, Yılmaz KaraBilgeBRecep Tayyip Erdogan University, Faculty of Medicine, Department of Chest Disease, Rize, Turkey. Electronic address: bilge.yilmazkara@erdogan.edu.tr., Nur Hürsoy, Neşe Merve Güner Zırıh, Songül Özyurt, and Ünal Şahin.
• Recep Tayyip Erdogan University, Faculty of Medicine, Department of Chest Disease, Rize, Turkey. Electronic address: aziz.gumus@erdogan.edu.tr.
• Clinics (Sao Paulo). 2024 Jan 1; 79: 100463100463.

ObjectivePleural effusion is a common medical problem. It is important to decide whether the pleural fluid is a transudate or an exudate. This study aims to measure the attenuation values of pleural effusions on thorax computed tomography and to investigate the efficacy of this measurement in the diagnostic separation of transudates and exudates.Materials And Methods380 cases who underwent thoracentesis and thorax computed tomography with pleural effusion were classified as exudates or transudates based on Light's criteria. Attenuation measurements in Hounsfield units were performed through the examination of thorax computed tomography images.Results380 patients were enrolled (39 % women), the mean age was 69.9 ± 15.2 years. 125 (33 %) were transudates whereas 255 (67 %) were exudates. The attenuation values of exudates were significantly higher than transudates (15.1 ± 5.1 and 5.0 ± 3.4) (p < 0.001). When the attenuation cut-off was set at ≥ 10 HU, exudates were differentiated from transudates at high efficiency (sensitivity is 89.7 %, specificity is 94.4 %, PPV is 97 %, NPV is 81.9 %). When the cut-off value was accepted as < 6 HU, transudates were differentiated from exudates with 97.2 % specificity.ConclusionThe attenuation measurements of pleural fluids can be considered as an efficacious way of differentiating exudative and transudative pleural effusions.Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.

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