Diagnosing pneumothorax with ultrasonography

Izcue, Aitor Lasarte; Melado, J. M. Navasa; Rodríguez, Gerardo Blanco; Gonzalez, Isabel; Blanco, Johana

doi:10.1016/j.rxeng.2014.05.005

Cited by 1 publication

(1 citation statement)

References 24 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of the US were documented as negative or positive for pneumothorax. Pneumothorax was diagnosed based on the absence of normal lung sliding or comet-tail artifact, with or without lung point 29 (Figure 1). Depending on the number of intercostal spaces where pneumothorax was detectable, positive cases were graded as 1, 2, or 3 (i.e., grade 1: seen above the clavicle or only in first intercostal space; grade 2: seen in first 2 intercostal spaces, and grade 3: seen in all 3 intercostal spaces).…”

Section: Methodsmentioning

confidence: 99%

Limited Chest Ultrasound to Replace CXR in Diagnosis of Pneumothorax Post Image-Guided Transthoracic Interventions

et al. 2021

View full text Add to dashboard Cite

Purpose: To assess the diagnostic accuracy of limited chest ultrasound in detecting pneumothorax following percutaneous transthoracic needle interventions using chest X-ray (CXR) as the reference standard. Methods: With IRB approval, after providing consent, asymptomatic patients after percutaneous transthoracic needle interventions were enrolled to undergo limited chest ultrasound in addition to CXR. A chest Radiologist blinded to the patient’s prior imaging performed a bedside ultrasound, scanning only the first 3 anterior intercostal spaces. Pneumothorax diagnosed on CXR was categorized as small or large and on ultrasound as grades 1, 2, or 3 when detected in 1, 2, or 3 intercostal spaces, respectively. Results: 38 patients underwent 36 biopsies (34 lungs, 1 pleura, and 1 mediastinum) and 2 coil localizations. CXR showed pneumothorax in 13 patients. Ultrasound was positive in 10 patients, with 9 true-positives, 1 false-positive, 4 false-negatives, and 24 true-negatives. The false positive results were due to apical subpleural bullae. The false-negative results occurred in 2 small apical and 2 focal pneumothoraces at the needle entry sites. Four pneumothoraces were categorized as large on CXR, all of which were categorized as grade 3 on ultrasound. Sensitivity and specificity of US for detection of pneumothorax of any size were 69.23% (95%CI 38.6%, 90.1%) and 96.0% (95%CI 79.6%, 99.9%), and for detection of large pneumothorax were 100% (95%CI 39.8%, 100%) and 100% (95%CI 89.7%, 100%). Conclusions: Results of this prospective study is promising. Limited chest ultrasound could potentially replace CXR in the management of postpercutaneous transthoracic needle intervention patients.

show abstract

Section: Methodsmentioning

confidence: 99%