Sonographic Diagnosis of a Pneumothorax Inapparent on Plain Radiography: Confirmation by Computed Tomography

Kirkpatrick, Andrew W.; Ng, Alexander K.; Dulchavsky, Scott A.; Lyburn, ID; Harris, A.C.; Torregianni, William; Simons, Richard K.; Nicolaou, Savvas

doi:10.1097/00005373-200104000-00029

Cited by 65 publications

(44 citation statements)

References 13 publications

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“…Inflammatory diseases of the lung are frequently associated with basal pleural effusions, which can be detected by US. This modality can also be useful in the follow-up of a patient with pulmonary consolidation, since it allows visualization of changes involving the inflammatory process after therapy [32]. Although data based on the study of a small series of patients with bronchopneumonia suggest that contrast-enhanced US performed with SonoVue â can be helpful in this setting, the results are still inconclusive.…”

Section: Pulmonary Diseasesmentioning

confidence: 99%

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo

Filabozzi

Varriale

et al. 2008

Journal of Ultrasound

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Although numerous studies have been conducted on the use of ultrasonography (US) for the examination of thoracic structures, this procedure is not as widely accepted as abdominal US. The newer portable scanners can be used at the bedside to detect pleural malignancies and effusions, as well as peripheral lung nodules of the lung, even in seriously ill patients. Focal thickening of the pleura can be easily detected with US and further investigated with a US-guided biopsy. US guidance can also be used during percutaneous drainage of pleural effusion or transthoracic biopsy of peripheral lung lesions, thus reducing the incidence of procedure-related pneumothorax to almost zero. We review the current literature on thoracic US and present our clinical experience with the technique in large groups of patients with pleural and peripheral lung diseases.Sommario L'ecografia del torace non è ancora diffusa quanto quella addominale, nonostante una notevole quantità di studi ne attesti l'importanza. Le apparecchiature più recenti permettono di diagnosticare neoplasie, versamenti pleurici e noduli polmonari periferici al letto del paziente, anche nei casi più gravi. L'ispessimento pleurico focale è facilmente messo in luce dall'ecografia e può essere ulteriormente studiato tramite la biopsia ecoguidata. Questa può essere praticata anche su lesioni polmonari periferiche, riducendo quasi a zero il rischio di pneumotorace. In questo articolo esaminiamo la letteratura recente sull'ecografia del torace e presentiamo la nostra esperienza clinica su numerosi pazienti con patologia pleurica e della periferia polmonare. ª

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Section: Pulmonary Diseasesmentioning

confidence: 99%

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Sperandeo

Filabozzi

Varriale

et al. 2008

Journal of Ultrasound

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“…11 Although more frequent use of US in chest trauma in the evaluation for traumatic epicardial or pleural effusion, research has shown that US of the thorax is highly accurate for the diagnosis of pneumothorax. [12][13][14] Recent researches describe that chest US is more accurate in diagnosis of pneumothorax in comparison with CXR. 15 US is an accurate, rapid and dynamic tool for diagnosis of lung contusion in comparison with supine CXR.…”

Section: Introductionmentioning

confidence: 99%

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

et al. 2017

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Background: Chest trauma is responsible for more than 20 to 25% of all traumatic death. Chest trauma is the second leading cause of traumatic death in each year. In order to keep the prognosis of patients with chest trauma relatively good, the patient should be diagnosed rapidly & managed adequately. Chest ultrasound is a safe, rapid and accurate method in diagnosing chest trauma.Methods: A total of 50 patients were enrolled in this study. Objectives were to assess the accuracy of bedside chest US in detection of either haemothorax, pneumothorax or lung contusion in chest trauma patients. All the patients underwent chest US, CXR, and chest CT. The data from ultrasound and CXR were compared with the gold standard CT. Then the accuracy of which were calculated.Results: Showed that Motorcar accidents are the most common cause for chest trauma and most patients were presented by chest pain and dyspnea. Chest ultrasound specificity in diagnosing pneumothorax was higher than sensitivity, 100% and 81% respectively, with over all accuracy 88%. Supine CXR showed sensitivity (75%), specificity (88.9%) and accuracy (80%) which are good numbers but still lower than chest US. Chest US Detection of haemothorax by chest had showed 100% sensitivity, 90% specificity and 96% accuracy.Conclusions: Chest ultrasound is highly accurate tool for detection of pneumothorax, haemothorax and less lung contusion in chest trauma. Chest ultrasound is a useful tool for the emergency physician for bedside rapid and accurate diagnosis without interruption of the resuscitation and without transferring the patient for the radiology unit.

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“…[11][12][13] Historically, PTX has been diagnosed in humans based on clinical suspicion, physical examination, and chest radiography (CXR), but with inconsistent reliability. [14][15][16][17][18] In small animal veterinary patients, physical examination has been likewise unreliable, and thoracic radiography is considered the mainstay for the diagnosis of PTX and other thoracic trauma. 9 However, CXR in humans increases risk of clinical deterioration in traumatized and intensive care patients, involves radiation exposure, incurs delay in diagnosis, and is prone to misinterpretation.…”

Section: Introductionmentioning

confidence: 99%

“…9 However, CXR in humans increases risk of clinical deterioration in traumatized and intensive care patients, involves radiation exposure, incurs delay in diagnosis, and is prone to misinterpretation. [14][15][16]18,[19][20][21] In traumatized dogs and cats, CXR poses similar concerns. Transport to the radiology area, requiring physical movement and restraint of the patient, increases stress and oxygen demand, potentially compromising critically injured dogs and cats.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

Lisciandro¹,

Lagutchik²,

Mann³

et al. 2008

J Vet Emergen Crit Care

115

132

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Objective: To estimate the relative accuracy of a thoracic focused assessment with sonography for trauma (TFAST) protocol for rapid diagnosis of pneumothorax (PTX) and other thoracic injury in traumatized dogs. Design: Prospective case series. Setting: Private veterinary emergency center. Animals: One hundred and forty-five client-owned dogs evaluated within 24-hours of injury. Interventions: Thoracic focused assessment with sonography for trauma protocol. Measurements and Main Results: Traumatized dogs were evaluated with a conventional ultrasound (US) machine using a standardized 4-point thoracic FAST protocol before thoracic radiography (CXR) and thoracocentesis. PTX was diagnosed by the absence of the 'glide sign,' defined as the lack of the normal dynamic interface between lung margins gliding along the thoracic wall during respiration. Concurrent thoracic trauma was diagnosed by the presence of pleural or pericardial fluid or the presence of a 'step sign,' defined as an abnormal glide sign. Accuracy of TFAST was calculated relative to CXR findings. Results: Overall sensitivity (Se), specificity (Sp), and accuracy of TFAST relative to CXR were 78.1% (95% CI; 61.5, 89.9), 93.4% (95% CI; 87.4, 97.1), and 90.0%, respectively. Se and Sp were higher in dogs with penetrating trauma (93.3%, 96.0%) and for the evaluator with the most clinical experience (95.2%, 96.0%); only Se between the most experienced compared with others was statistically significant (Po0.05). TFAST documented other concurrent thoracic injury. Median time for TFAST was 3 minutes. Conclusions and Clinical Relevance: TFAST has the potential to rapidly diagnose PTX and other thoracic injury and guide therapy, including potentially life-saving interventions, in traumatized dogs.

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Sonographic Diagnosis of a Pneumothorax Inapparent on Plain Radiography: Confirmation by Computed Tomography

Cited by 65 publications

References 13 publications

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Role of thoracic ultrasound in the assessment of pleural and pulmonary diseases

Role of bedside sonography in the assessment of patients with chest trauma in the emergency department of Suez Canal University Hospital

Evaluation of a thoracic focused assessment with sonography for trauma (TFAST) protocol to detect pneumothorax and concurrent thoracic injury in 145 traumatized dogs

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