Muhammad Imran, Muhammad Asghar Bhatti, Munnaza Nazir, Tariq Mahmud Mirza.
Diagnostic accuracy of chest ultrasonography in the early detection of pneumothorax taking chest CT scan as gold standard.
Pak J Radiol May ;28(1):1-8.

ABSTRACT BACKGROUND: Early detection and treatment of pneumothorax is critically important. It often remains undiagnosed after trauma and may rapidly lead to tension pneumothorax and subsequently to cardiac arrest. A quick bedside chest ultrasound may expedite the diagnosis, treatment and resuscitation of patient. It is an easy and simple technique which does not require higher expertise. OBJECTIVE: To determine diagnostic accuracy of chest ultrasound in the detection of pneumothorax taking chest CT scan as gold standard. METHODOLOGY: The ultrasound chest performed on patient lying supine, scanning both lung fields. With use of high frequency linear probe one can clearly distinguish the visceral and parietal pleura, lung sliding and comet tail artifact representing normal lung. Absence of lung sliding and comet tail artifact representing pneumothorax. The results then compared with gold standard multislice (64) CT scan of chest. RESULTS: In our study, out of 275 cases, 65.82%(n=181) were between 18-40 years of age while 34.18%(n=94) were between 41-60 years of age, mean+sd was calculated as 35.31+8.96 years, 58.91%(n=162) were male and 41.09%(n=113) were females, frequency of pneumothorax on CT was recorded as 8.36%(n=23), the diagnostic accuracy of chest ultrasound to detect pneumothorax taking chest CT scan as gold standard shows sensitivity, specificity, positive predictive value, negative predictive value and accurate as 78.26%, 96.83%, 69.23%, 97.99% and 95.27% respectively. CONCLUSION: Chest ultrasound is a useful, radiation free, easy and rapid technique in the detection of pneumothorax as a bedside procedure in emergency trauma cases.

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