Abstract
Backround: Radiologic data remains the gold standard for the diagnosis of pneumothorax (PTX). However, emerging data demonstrate superior sensitivity of detecting PTX by chest ultrasonography (US), a widely available, radiation-sparing method. The aim of our study is to assess the diagnostic accuracy of US against chest radiography (CRX) for the detection of PTX using thoracic computed tomography (CT) as the reference stanndard.
Methods: We conducted a prospective study of 68 patients treated for PTX of all causes, between 2018-2019. Chest US and radiographic findings were compared with CT. Patients were evaluated by performing bedside US (SonoScape X3, Medical Corp.),equipped with a high-frequency (4-16 MHz) linear probe. For the purpose of the study, physicians performing the US, were blinded to the CRX and CT findings. Patients presented with subcutaneous emphysema were excluded from the study.
Results: The majority of patients were males (77%), with an average age of 46±27 years. In all the studied population (n=68), chest CT confirmed the diagnosis of PTX. Overall US yield a higher sensitivity [91.5% (n=62] in predicting PTX, compared with supine CRX [64.8% (n=44]. CRX had a slightly higher specificity than US (98.2% vs. 96.1%) and higher positive predictive values (96.0%vs.91.6%).
Conclusions: Our study supports the available literature in favor of the superiority in sensitivity of chest US over CRX, in the detection and assessment of patients with PTX. Considering the current lack of well-designed randomized trials, further studies are warranted in order to confirm a definite benefit, direct a correct operator implementation, thus optimizing patient’s outcome.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1142.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020