Diagnostische Wertigkeit der transthorakalen Sonografie vergleichend zur Thoraxübersicht beim Nachweis eines postinterventionellen Pneumothorax

Kreuter, Michael; Eberhardt, R; Wenz, Heinrich; Schmitteckert, H.; Heußel, Claus-Peter; Herth, Felix J.F.

doi:10.1055/s-0031-1273316

Cited by 28 publications

(17 citation statements)

References 9 publications

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“…Furthermore, a pneumothorax following transbronchial biopsy can be reliably excluded with US (sensitivity 100% and specificity 83%) [30]. Soldati et al [31] showed that US was superior to chest radiographs in diagnosing pneumothoraces following blunt chest trauma.…”

Section: Diagnostic Transthoracic Ultrasonographymentioning

confidence: 99%

Transthoracic Ultrasonography for the Respiratory Physician

Koegelenberg

Groote-Bidlingmaier²,

Bolliger³

2012

Respiration

133

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Transthoracic ultrasonography is still not utilized to its full potential by respiratory physicians, despite being a well-established and validated imaging modality. It allows for an immediate and mobile assessment that can potentially augment the physical examination of the chest. Ultrasound (US)-assisted procedures can be performed by a single clinician with no sedation and with minimal monitoring, even outside of theatre. The main indications for the use of transthoracic US are: the qualitative and quantitative description of pleu-ral effusions, pleural thickening, diaphragmatic dysfunction and chest-wall and pleural tumours. It may also be used to visualise lung tumours and other parenchymal pulmonary processes provided they abut the pleura. It is at least as sensitive as chest radiographs as far as the detection of a pneumothorax is concerned. It is the ideal tool to assist with thoracocentesis and drainage of effusions. The US-assisted fine-needle aspiration and/or cutting-needle biopsy of extrathoracic lymph nodes, lesions arising from the chest wall, pleura, peripheral lung and mediastinum, are safe and have a high yield in the hands of chest physicians. US may also guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations and lung abscesses, provided the chest wall is abutted. Advanced applications of transthoracic US include the diagnosis of pulmonary embolism.

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Section: Diagnostic Transthoracic Ultrasonographymentioning

confidence: 99%

Transthoracic Ultrasonography for the Respiratory Physician

Koegelenberg

Groote-Bidlingmaier²,

Bolliger³

2012

Respiration

133

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“…The use of chest ultrasound to diagnose pneumothorax has long been questioned. However, in recent years, numerous clinical trials have demonstrated that pneumothorax can reliably be detected by thoracic ultrasound with a high sensitivity (80-100%) and specificity (83-100%) [3,9,10,11,12,13,14,15]. Consequently, chest sonography has gained increased interest also in emergency medicine due to its high sensitivity (>90%) and specificity (99%) [10,13,15,16,17,18].…”

Section: Sonography and Sonomorphology Of Important Thoracic Emergenciesmentioning

confidence: 99%

“…Adding power color Doppler imaging improves this examination [10]. Further diagnostic criteria are absence of B-lines, absence of lung pulse (in M-mode or power color Doppler) and finally the detection of a lung point (fig.…”

Section: Sonography and Sonomorphology Of Important Thoracic Emergenciesmentioning

confidence: 99%

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Emergency Ultrasound of the Chest

Kreuter

Mathis

2014

Respiration

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Thoracic ultrasound is a noninvasive and portable diagnostic tool which is highly indicated for an initial workup of thoracic emergencies. The suspicion of a pneumothorax, pneumonia, pulmonary embolism or a lung contusion after trauma can be quickly assessed using ultrasound. Main advantages are its good availability and the steep learning curve. Another advantage of thoracic sonography is that this rapid, symptom-based examination has a high sensitivity and specificity. However, a disadvantage is that only pleura-affecting lesions or lesions visible through a sound window, e.g. an effusion or a subpleural consolidation, can be reached.

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“…With respect to the literature [1,5,19,26,27,31,32], our study population is on the whole representative; however, the average age is slightly older in comparison, primarily due to the higher proportion of patients with post-interventional or postoperative pneumothorax (after pacemaker implantation, defibrillation or cardiac surgery).…”

mentioning

confidence: 99%

Value of Digital Radiography in Expiration in Detection of Pneumothorax

Thomsen

Natho

Feigen

et al. 2013

Fortschr Röntgenstr

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!Purpose: The purpose of this study was to find out whether pneumothorax detection and exclusion is superior in expiratory digital chest radiography. Materials and Methods: 131 patients with pneumothorax with paired inspiratory and expiratory chest radiographs were analyzed regarding localization and size of pneumothorax. Sensitivity, specificity, negative (npv) and positive predictive value (ppv) as well as the positive (LR+) and negative likelihood ratio (LR-) were determined in a blinded randomized interobserver study with 116 patients. The evaluation was performed by three board-certified radiologists. Results: In 131 patients, there were 139 pneumothoraces, 135 (97.1 %) were located apical, 88 (63.3 %) lateral and 33 (23.7 %) basal. Sensitivity was 99 % for inspiratory and 97 % for expiratory radiographs. The interobserver study yielded a mean sensitivity of 86.1 %/86.1 %, specificity of 97.3 %/93.4 %, npv of 88.7 %/88.5 % and ppv of 96.7 %/92.1 % for inspiration/expiration. For inspiratory radiographs the LR+/LR-were 40.2/0.14 and for expiration 13.9 and 0.15. McNemar-Test showed no significant difference for the detection of pneumothoraces in in-/exspiration. Conclusion: Inspiratory and expiratory digital radiographs are equally suitable for pneumothorax detection. Inspiratory radiographs are recommended as the initial examination of choice for pneumothorax detection, an additional expiratory radiograph is only recommended in doubtful cases.

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Diagnostische Wertigkeit der transthorakalen Sonografie vergleichend zur Thoraxübersicht beim Nachweis eines postinterventionellen Pneumothorax

Cited by 28 publications

References 9 publications

Transthoracic Ultrasonography for the Respiratory Physician

Transthoracic Ultrasonography for the Respiratory Physician

Emergency Ultrasound of the Chest

Value of Digital Radiography in Expiration in Detection of Pneumothorax

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