Ultrasound Detection of Pneumothorax Compared with Chest X-Ray and Computed Tomography Scan

2011 ◽  
Vol 77 (4) ◽  
pp. 480-483 ◽  
Author(s):  
Khanjan Nagarsheth ◽  
Stanley Kurek

Pneumothorax after trauma can be a life threatening injury and its care requires expeditious and accurate diagnosis and possible intervention. We performed a prospective, single blinded study with convenience sampling at a Level I trauma center comparing thoracic ultrasound with chest X-ray and CT scan in the detection of traumatic pneumothorax. Trauma patients that received a thoracic ultrasound, chest X-ray, and chest CT scan were included in the study. The chest X-rays were read by a radiologist who was blinded to the thoracic ultrasound results. Then both were compared with CT scan results. One hundred and twenty-five patients had a thoracic ultrasound performed in the 24-month period. Forty-six patients were excluded from the study due to lack of either a chest X-ray or chest CT scan. Of the remaining 79 patients there were 22 positive pneumothorax found by CT and of those 18 (82%) were found on ultrasound and 7 (32%) were found on chest X-ray. The sensitivity of thoracic ultrasound was found to be 81.8 per cent and the specificity was found to be 100 per cent. The sensitivity of chest X-ray was found to be 31.8 per cent and again the specificity was found to be 100 per cent. The negative predictive value of thoracic ultrasound for pneumothorax was 0.934 and the negative predictive value for chest X-ray for pneumothorax was found to be 0.792. We advocate the use of chest ultrasound for detection of pneumothorax in trauma patients.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  

Background. The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT  scan as a screening measure of COVID-19 in trauma patients. Methods. This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT scans were evaluated in a blinded manner, and the main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two Radiological Society of North America (RSNA) categories with the highest probability of COVID-19 pneumonia (i.e., typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID-19 pneumonia into “negative CT scan group.” Results. Chest CT scan had a sensitivity of 68%, specificity of 56%, positive predictive value of 34.8%, negative predictive value of 83.7%, and accuracy of 59.3% in detecting COVID-19 among trauma patients. Moreover, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals, a sensitivity of 100%, specificity of 66.7%, and negative predictive value of 100% were obtained ( p value: 0.05). Conclusion. Findings of the study indicated that the CT scan’s sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 compared with nontraumatic people.


2020 ◽  
Author(s):  
Liqa A Rousan ◽  
Eyhab Elobeid ◽  
Musaab Karrar ◽  
Yousef Khader

Abstract Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females and 38 (43.2%) males) were admitted to the hospital with confirmed COVID-19 pneumonia. Their age ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia.


2020 ◽  
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  

Abstract Purpose: The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients.Methods: This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT-scans were evaluated in a blinded manner and main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two RSNA categories with the highest probability of COVID pneumonia (i.e. typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID pneumonia into “negative CT scan group”.Results: Chest CT scan had a sensitivity (68%), specificity (56%), positive predictive value (34.8%), negative predictive value (83.7%), and accuracy (59.3%) in detecting COVID-19 among trauma patients. Also, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals a sensitivity of 100% and a specificity of 66.7% and a negative predictive value of 100% was obtained.Conclusion: Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 in comparison to non-traumatic people.


2020 ◽  
Author(s):  
Hossein Abdolrahimzadeh Fard ◽  
Salahaddin Mahmudi-Azer ◽  
Sepideh Sefidbakht ◽  
Pooya Iranpour ◽  
Shahram Bolandparvaz ◽  
...  

Abstract Background: The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients. Method: This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT-scans were evaluated in a blinded manner and main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two RSNA categories with the highest probability of COVID pneumonia (i.e. typical and indeterminate) were merged into the “positive CT scan group” and those with radiologic features with the least probability of COVID pneumonia into “negative CT scan group”.Results: Chest CT scan had a sensitivity (68%), specificity (56%), positive predictive value (34.8%), negative predictive value (83.7%), and accuracy (59.3%) in detecting COVID-19 among trauma patients. Also, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals a sensitivity of 100% and a specificity of 66.7% and a negative predictive value of 100% was obtained.Conclusion: Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 in comparison to non-traumatic people.


2017 ◽  
Vol 2 (4) ◽  
pp. 181-186 ◽  
Author(s):  
Tilak Pathak ◽  
Malvinder S. Parmar

AbstractBackgroundPleural effusion is common and can cause significant morbidity. The chest X-ray is often the initial radiological test, but additional tests may be required to reduce uncertainty and to provide additional diagnostic information. However, additional exposure and unnecessary costs should be prevented. The objective of the study was to assess the clinical benefit of an additional chest computed tomography (CT) scan over plain chest X-ray alone in the management of patients with pleural effusion.MethodsRetrospective analysis in 94 consecutive patients with pleural effusion who underwent chest X-ray and CT scan over an 18-month period in a single institution. All chest X-ray and CT scan reports were compared and correlated with clinical parameters in order to assess their utility in the clinical management. No blinding was applied.ResultsIn 75 chest CT scan reports (80 %), information provided by the radiologist did not change clinical management when compared to plain chest X-ray alone and did not provide any additional information over chest X-ray. Only 2/49 (4 %) of the native chest CT scan reports provided clinically relevant information as compared to 17/45 (38 %) contrast-enhanced chest CT scan reports (p<0.001).ConclusionsIn this retrospective cohort of patients with pleural effusion, an additional chest CT scan was not useful in the majority of patients. However, if a chest CT scan is required, then a contrast-enhanced study after pleural aspiration should be performed. Further prospective studies are required to confirm these findings.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. TPS7111-TPS7111
Author(s):  
Virginie Westeel ◽  
Fabrice Barlesi ◽  
Jean Domas ◽  
Philippe Girard ◽  
Pascal Foucher ◽  
...  

TPS7111 Background: There are no robust data published on the follow-up after surgery for non-small cell lung cancer (NSCLC). Current international guidelines are informed by expert opinion. Most of them recommend regular follow-up with clinic visit and thoracic imaging, either chest X-ray of Chest CT-scan. The IFCT-0302 trial addresses the question whether a surveillance program with chest CT-scan and fiberoptic bronchoscopy can improve survival compared to a follow-up only based on physical examination and chest x-ray. There is no such trial ongoing over the world. Methods: The IFCT-0302 trial is a multicenter open-label controlled randomized phase III trial. The objective of the trial is to compare two follow-up programs after surgery for stage I-IIIa NSCLC. The primary endpoint is overall survival. Patients are randomly assigned to arm 1, minimal follow-up, including physical examination and chest x-ray; or arm 2, a follow-up consisting of physical examination and chest x-ray plus chest CT scan and fiberoptic bronchoscopy (optional for adenocarcinomas). In both arms, follow-up procedures are performed every 6 months during the first two postoperative years, and every year between the third and the fifth years. The main eligibility criteria include: completely resected stage I-IIIA (6th UICC TNM classification) or T4 (in case of nodules in the same lobe as the tumor) N0 M0 NSCLC, surgery within the previous 8 weeks. Patients who have received and/or who will receive pre/post-operative chemotherapy and/or radiotherapy are eligible. Statistical considerations: 1,744 patients is required. Accrual status: 1,568 patients from 119 French centers had been included. The end of accrual can be expected for September 2012. Ancillary study: Blood samples are collected in 1000 patients for genomic high density SNP micro-array analysis. This collection will contribute to the French genome wide association study (gwas) of lung cancer gene susceptibility, and the genetic factors predictive of survival and lung cancer recurrence will be analyzed.


CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 40S
Author(s):  
Beverly D. Delacruz ◽  
Nerissa A. Deleon ◽  
Milagros S. Bautista ◽  
Fernando Ayuyao ◽  
Teresita Deguia

10.3823/2550 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Luis Eduardo Almeida de Souza ◽  
Karlla Lorena Dos Santos Anjos ◽  
Danielle Oliveira Sousa ◽  
Gabriel De Jesus da Fonseca Loureiro ◽  
Deborah Marques Centeno ◽  
...  

Background: The congenital malformation of the posterolateral portion of the diaphragm is called the Bochdalek hernia, and was first described in 1948 by anatomy professor Bochdalek. The diagnosis in adults is extremely rare, being in the majority, an occasional finding in a chest x-ray. Case: The authors report a Bochdalek Hernia case in an adult pacient, with complaints of dyspnea and epigastralgia refractory to pharmacological treatment. The diagnosis was confirmed after a chest CT scan. Conclusion: Bochdalek hernias are extremely rare in adults, commonly diagnosed in childhood. The importance of recognition of its diagnosis is crucial, so it should be always among differential diagnoses in radiology, due to the range of complications that may affect the patients.


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