1Associate Professor, Department of Radiology, School of Medical Sciences and Research, Sharda University, Greater Noida, U.P.
2Associate Professor, Department of TB and Chest Diseases, School of Medical Sciences and Research, Sharda University, Greater Noida, U.P.
Online published on 4 January, 2017.
Few studies have systematically evaluated the role of chest ultrasound(US) in the diagnosis of pneumothorax in a variety of clinical settings. In the present study, we assessed the role of chest US, in the diagnosis of pnemothorax in haemodynamically stable patients and assessed the average time for the diagnosis of pnemothorax by chest US.
A total of 136 hemodynamically stable patients who either had clinically suspected pneumothorax or were with chest tube in-situ for evaluation of residual pneumothorax, were included in the study. A sonographic diagnosis of “Pneumothorax” or “No Pneumothorax” was made. The time taken to make the diagnosis was also recorded.
Chest radiograph was then obtained in all patients and non contrast CT thorax was done only in whom the diagnosis of pneumothorax could not be confirmed on chest radiograph.
The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy of chest US were calculated considering chest radiograph (n=73) and computed tomography (n=63) as ‘gold standard’. The performance of chest US in the detection of pneumothorax was compared to the “gold standard” using a Kappa agreement test.
Ultrasound had a strong agreement with the ‘gold standard’ (kappa=0.70, p<0.05). The sensitivity of chest US to diagnose pneumothorax in our study was 89% and specificity was 87%. The average time taken for ultrasonographic examination of both lungs and evaluation of all sonographic signs was 5 minutes.
Chest ultrasound can be used as a primary imaging modality for the diagnosis of pneumothorax as it has high sensitivity and specificity.
Chest ultrasound, pneumothorax
